A Guide for Individuals and Families 1

Pandemic Influenza Planning:

A Guide for Individuals and Families

Get Information. Stay Informed.

U.S. Department of Health and Human Services

May 2006
2 www.pandemicflu.gov

“ While the Federal Government will use all resources at 

its disposal to prepare for and respond to an influenza 

pandemic, it cannot do the job alone. This effort 

requires the full participation of and coordination by 

all levels of government and all segments of society... 

perhaps most important, addressing the challenge will 

require active participation by individual citizens in 

each community across our Nation.” 

George W. Bush, President

United States of America

“ Pandemics are global in nature, but their impact is 

local. When the next pandemic strikes, as it surely 

will, it is likely to touch the lives of every individual, 

family, and community. Our task is to make sure that 

when this happens, we will be a Nation prepared.”

Michael O. Leavitt, Secretary

U.S. Department of Health and Human Services
A Guide for Individuals and Families 3

This guide is designed to help you understand the threat of a pandemic 

influenza outbreak in our country and your community. It describes 

commonsense actions you can take now in preparing for a pandemic. We 

cannot predict how severe the next pandemic will be or when it will occur, 

but being prepared may help lower the impact of an influenza pandemic 

on you and your family. Additional information including a planning 

checklist for individuals and families can be found at 

www.pandemicflu.gov.

What You Need to Know

An influenza (flu) pandemic is a worldwide outbreak of flu disease that occurs when a 

new type of influenza virus appears that people have not been exposed to before (or 

have not been exposed to in a long time). The pandemic virus can cause serious illness 

because people do not have immunity to the new virus. Pandemics are different from 

seasonal outbreaks of influenza that we see every year. Seasonal influenza is caused 

by influenza virus types to which people have already been exposed. Its impact on 

society is less severe than a pandemic, and influenza vaccines (flu shots and nasal-spray 

vaccine) are available to help prevent widespread illness from seasonal flu. 

Influenza pandemics are different from many of the other major public health and 

health care threats facing our country and the world. A pandemic will last much longer 

than most flu outbreaks and may include “waves” of influenza activity that last 6-8 

weeks separated by months. The number of health care workers and first responders 

able to work may be reduced. Public health officials will not know how severe a 

pandemic will be until it begins.

Pandemic Influenza –

 Get Informed. Be Prepared
4 www.pandemicflu.gov

Some Differences Between Seasonal Flu and Pandemic Flu

Seasonal Flu

Caused by influenza viruses that are similar 

to those already circulating among people.

Symptoms include fever, headache, tiredness, 

dry cough, sore throat, runny nose, and 

muscle pain. Deaths can be caused by 

complications such as pneumonia.

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). 

Every year in the United State, on average:

• 5% to 20% of the population gets the flu;

• More than 200,000 people are hospitalized 

from flu complications; and

• About 36,000 people die from flu.

Pandemic Flu

Caused by a new influenza virus that people 

have not been exposed to before. Likely 

to be more severe, affect more people, and 

cause more deaths than seasonal influenza 

because people will not have immunity to the 

new virus.

Symptoms similar to the common flu 

but may be more severe and complications 

more serious. 

Healthy adults may be at increased risk for 

serious complications.

The effects of a severe pandemic could be 

much more damaging than those of a regular 

flu season. It could lead to high levels of 

illness, death, social disruption, and economic 

loss. Everyday life could be disrupted because 

so many people in so many places become 

seriously ill at the same time. Impacts could 

range from school and business closings 

to the interruption of basic services such a 

public transportation and food delivery. 

In the last century there were three influenza pandemics. All of them were called 

pandemics because of their worldwide spread and because they were caused by a new 

influenza virus. The 1918 pandemic was especially severe. 

1918-1919 Most severe, caused at least 675,000 U.S. deaths and up tp 50 million deaths worldwide.

1957-1958 Moderately severe, caused at least 70,000 U.S. deaths and 1-2 million deaths worldwide.

1968-1969 Least severe, caused at least 34,000 U.S. deaths and 700,000 deaths worldwide.

A Historical Perspective
A Guide for Individuals and Families 5

Importance and Benefits of Being Prepared

The effects of a pandemic can be lessened if you prepare ahead of time. Preparing for a 

disaster will help bring peace of mind and confidence to deal with a pandemic. 

When a pandemic starts, everyone around the world 

could be at risk. The United States has been working 

closely with other countries and the World Health 

Organization (WHO) to strengthen systems to detect 

outbreaks of influenza that might cause a pandemic.

A pandemic would touch every aspect of society, so 

every part of society must begin to prepare. All have 

roles in the event of a pandemic. Federal, state, tribal, 

and local governments are developing, improving, and 

testing their plans for an influenza pandemic. Businesses, 

schools, universities, and other faith-based and 

community organizations are also preparing plans.

As you begin your individual or family planning, you may 

want to review your state’s planning efforts and those of 

your local public health and emergency preparedness officials. State plans and other 

planning information can be found at www.pandemicflu.gov/plan/checklists.html.

The Department of Health and Human Services (HHS) and other federal agencies are 

providing funding, advice, and other support to your state. The federal government will 

provide up-to-date information and guidance to the public if an influenza pandemic 

unfolds. For reliable, accurate, and timely information, visit the federal government’s 

official Web site at www.pandemicflu.gov.
6 www.pandemicflu.gov

Pandemic Influenza –

 Challenges and Preparation

As you and your family plan for an influenza pandemic, think about the challenges you 

might face, particularly if a pandemic is severe. 

You can start to prepare now to be able to respond to these challenges. The following 

are some challenges you or your family may face and recommendations to help 

you cope. In addition, checklists and other tools have been prepared to guide your 

planning efforts. A series of planning checklists can be found at 

www.pandemicflu.gov/plan/checklists.html.

Essential Services You Depend on May Be Disrupted

❖ Plan for the possibility that usual services may be disrupted. These could include 

services provided by hospitals and other healthcare facilities, banks, restaurants, 

government offices, telephone and cellular phone companies, and post offices. 

❖ Stores may close or have limited supplies. The planning checklists can help you 

determine what items you should stockpile to help you manage without these 

services

❖ Transportation services may be disrupted and you may not be able to rely on public 

transportation. Plan to take fewer trips and store essential supplies.

❖ Public gatherings, such as volunteer meetings and worship services, may be 

canceled. Prepare contact lists including conference calls, telephone chains, and 

email distribution lists, to access or distribute necessary information. 

❖ Consider that the ability to travel, even by car if there are fuel shortages, may be 

limited.

❖ You should also talk to your family about where family members and loved ones 

will go in an emergency and how they will receive care, in case you cannot 

communicate with them. 

❖ In a pandemic, there may be widespread illness that could result in the shut down 

of local ATMs and banks. Keep a small amount of cash or traveler’s checks in small 

denominations for easy use. 
A Guide for Individuals and Families 7

Food and Water Supplies May Be Interrupted and Limited

Food and water supplies may be interrupted so temporary shortages could occur. You 

may also be unable to get to a store. To prepare for this possibility you should store at 

least one to two weeks supply of non-perishable food and fresh water for emergencies. 

Food

❖ Store two weeks of nonperishable food. 

❖ Select foods that do not require refrigeration, preparation (including the use of 

water), or cooking.

❖ Insure that formulas for infants and any child’s or older person’s special nutritional 

needs are a part of your planning.

Water

❖ Store two weeks of water, 1 gallon of water per person per day. (2 quarts for 

drinking, 2 quarts for food preparation/sanitation), in clean plastic containers. 

Avoid using containers that will decompose or break, such as milk cartons or glass 

bottles.

Being Able to Work May Be Difficult or Impossible

❖ Ask your employer how business will continue during a pandemic.

❖ Discuss staggered shifts or working at home with your employer. Discuss 

telecommuting possibilities and needs, accessing remote networks, and using 

portable computers.

❖ Discuss possible flexibility in leave policies. Discuss with your employer how much 

leave you can take to care for yourself or a family member

❖ Plan for possible loss of income if you are unable to work or the company you work 

for temporarily closes. 

For the Business Checklist visit: http://www.pandemicflu.gov/plan/businesschecklist.

html 
8 www.pandemicflu.gov

Schools and Daycare Centers May Be Closed for an 

Extended Period of Time 

Schools, and potentially public and private preschool, childcare, trade schools, and 

colleges and universities may be closed to limit the spread of flu in the community 

and to help prevent children from becoming sick. Other school-related activities and 

services could also be disrupted or cancelled including: clubs, sports/sporting events, 

music activities, and school meals. School closings would likely happen very early in a 

pandemic and could occur on short notice. 

❖ Talk to your teachers, administrators, and 

parent-teacher organizations about your 

school’s pandemic plan, and offer your 

help.

❖ Plan now for children staying at home 

for extended periods of time, as school 

closings may occur along with restrictions 

on public gatherings, such as at malls, 

movie theaters. 

❖ Plan home learning activities and exercises 

that your children can do at home. Have 

learning materials, such as books, school 

supplies, and educational computer 

activities and movies on hand. 

❖ Talk to teachers, administrators, and 

parent-teacher organizations about 

possible activities, lesson plans, and 

exercises that children can do at home 

if schools are closed. This could include 

continuing courses by TV or the internet.

❖ Plan entertainment and recreational activities that your children can do at home. 

Have materials, such as reading books, coloring books, and games, on hand for 

your children to use. 

For the “Childcare, School, and University Checklist,” visit: http://www.pandemicflu.

gov/plan/tab5.html
A Guide for Individuals and Families 9

Medical Care for People with Chronic Illness Could be 

Disrupted 

In a severe pandemic, hospitals and doctors’ offices may be overwhelmed. 

❖ If you have a chronic disease, such as heart disease, high blood pressure, diabetes, 

asthma, or depression, you should continue taking medication as prescribed by 

your doctor.

❖ Make sure you have necessary 

medical supplies such as glucose 

and blood-pressure monitoring 

equipment.

❖ Talk to your healthcare provider 

to ensure adequate access to your 

medications.

❖ If you receive ongoing medical care 

such as dialysis, chemotherapy, 

or other therapies, talk with your 

health care provider about plans to 

continue care during a pandemic. 

❖ A ”Family Emergency Health Information Sheet” is provided in this guide and at: 

http://www.pandemicflu.gov/planguide/familyhealthinfo.html 
10 www.pandemicflu.gov

Pandemic Influenza –

 Prevention and Treatment

Stay Healthy

These steps may help prevent the spread of respiratory illnesses such as the flu:

❖ Cover your nose and mouth with a tissue when you cough or sneeze—throw the 

tissue away immediately after you use it.

❖ Wash your hands often with 

soap and water, especially after 

you cough or sneeze. If you are 

not near water, use an alcoholbased (60-95%) hand cleaner. 

❖ Avoid close contact with people 

who are sick. When you are sick, 

keep your distance from others 

to protect them from getting 

sick too.

❖ If you get the flu, stay home from work, school, and social gatherings. In this way 

you will help prevent others from catching your illness.

❖ Try not to touch your eyes, nose, or mouth. Germs often spread this way. 

Vaccination

Vaccines are used to protect people from contracting a virus once a particular threat is 

identified. After an individual has been infected by a virus, a vaccine generally cannot 

help to combat it. Because viruses change over time, a specific pandemic influenza 

vaccine cannot be produced until a pandemic influenza virus emerges and is identified. 

Once a pandemic influenza virus has been identified, it will likely take 4-6 months to 

develop, test, and begin producing a vaccine. 

While there is currently no human pandemic influenza in the world, the federal 

government is facilitating production of vaccines for several existing avian influenza 

viruses. These vaccines may provide some protection should one of these viruses 
A Guide for Individuals and Families 11

change and cause an influenza pandemic. The supply of pandemic vaccine will 

be limited, particularly in the early stages of a pandemic. Efforts are being made 

to increase vaccine-manufacturing capacity in the United States so that supplies of 

vaccines would be more readily available. In addition, research is underway to develop 

new ways to produce vaccines more quickly. 

Antivirals

A number of antiviral drugs are approved by the U.S. Food and Drug Administration 

to treat and prevent seasonal influenza. Some of these antiviral medications may be 

effective in treating pandemic influenza. These drugs may help prevent infection in 

people at risk and shorten the duration of symptoms in those infected with pandemic 

influenza. However, it is unlikely that antiviral medications alone would effectively 

contain the spread of pandemic influenza. The federal government is stockpiling 

antiviral medications that would most likely be used in the early stages of an influenza 

pandemic and working to develop new antiviral medications. These drugs are available 

by prescription only. 

Stay Informed

❖ Knowing the facts is the best preparation. Identify sources you can count on for 

reliable information. If a pandemic occurs, having accurate and reliable information 

will be critical.

❖ Reliable, accurate, and timely information is available at www.pandemicflu.gov. 

❖ Another source for information on pandemic influenza is the Centers for Disease 

Control and Prevention (CDC) Hotline at: 1-800-CDC-INFO (1-800-232-4636). 

This line is available in English and Spanish, 24 hours a day, 7 days a week.

❖ Look for information on your local and state government Web sites. Links are 

available to each state department of public health at http://www.pandemicflu.

gov/plan/tab2.html#stateinfo. 

❖ Listen to local and national radio, watch news reports on television, and read your 

newspaper and other sources of printed and web-based information. 

❖ Talk to your local health care providers and public health officials.
12 www.pandemicflu.gov

Questions and Answers

Will bird flu cause the next influenza pandemic? 

 Avian influenza (bird flu) is a disease of wild and farm birds caused by avian 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 (for example: 

domesticated chickens, ducks, and turkeys). It is important not to handle, play with, 

or pick up dead birds. Information on who to contact in your state is at: http://www.

pandemicflu.gov/state/statecontacts.html 

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. Experts around the world are watching for 

changes in bird flu viruses that could lead to an influenza pandemic. 

Is it safe to eat poultry? 

Yes, it is safe to eat properly cooked poultry. Cooking destroys germs, including 

bird flu viruses. The United States maintains trade restrictions on the 

importation of poultry and poultry products from countries where the 

highly pathogenic H5N1 avian influenza strain has been detected in 

commercial or traditionally raised poultry, not in wild or migratory birds.

Guidelines for the safe preparation of poultry include the following:

❖ Wash hands before and after handling food. 

❖ Keep raw poultry and its juices away from other foods. 

❖ Keep hands, utensils, and surfaces, such as cutting boards, clean. 

❖ Use a food thermometer to ensure food has reached the safe internal 

temperature – in all parts of the bird. Cook poultry to at least 165°F 

to kill food-borne germs that might be present, including the avian 

influenza virus.

For more information, see poultry preparation fact sheets at: http://www.fsis.usda.gov/

Fact_Sheets/Poultry_Preparation_Fact_Sheets/index.asp
A Guide for Individuals and Families 13

What types of birds can carry bird flu viruses? 

Avian influenza viruses can infect chickens, turkeys, pheasants, quail, ducks, geese, and 

guinea fowl, as well as a wide variety of other birds, including migratory waterfowl. 

Each year, there is a flu season for birds just as there is for humans and, as with 

people, some forms of the flu are worse than others, depending on how strong the 

virus. A weak virus may cause only mild illness in infected poultry and birds but a 

strong virus could cause severe and extremely contagious illness, and even death, 

among infected poultry and birds. 

Will the seasonal flu shot protect me against pandemic influenza? 

❖ No, it won’t protect you against pandemic influenza. But flu shots can help you to 

avoid seasonal flu.

❖ Get a flu shot to help protect you from seasonal flu.

❖ Get a pneumonia shot to prevent secondary infection if you are over the age of 65 

or have a chronic illness such as diabetes or asthma. For specific guidelines, talk 

to your health care provider or call the Centers for Disease Control and Prevention 

(CDC) Hotline at 1-800-232-4636.

❖ Make sure that your family’s immunizations are up-to-date.

What is the U.S. government doing to prepare for pandemic influenza?

The U.S. government has been preparing for pandemic influenza for several years. 

In November 2005, the President announced the National Strategy for Pandemic 

Influenza. Ongoing preparations include the following:

❖ Monitoring migratory and wild birds for avian flu.

❖ Working with the World Health Organization (WHO) and other nations to help 

detect human cases of bird flu and respond to an influenza pandemic, if one 

begins.

❖ Supporting the manufacturing and testing of influenza vaccines, including finding 

more reliable and quicker ways to make large quantities of vaccines through cellbased technologies. 

❖ Developing a national stockpile of antiviral drugs to help treat and control the 

spread of disease.

❖ Supporting the efforts of federal, state, tribal, and local health agencies to prepare 

for and respond to pandemic influenza, including hosting planning summits with 

state and local leaders in each state.

❖ Working with federal agencies to prepare and to encourage communities, 

businesses, and organizations to plan for pandemic influenza. These efforts have 

included joint exercises in pandemic preparation. 
14 www.pandemicflu.gov

Pandemic Flu Planning

 Checklist for Individuals & Families

You can prepare for an influenza pandemic now. You should know both the magnitude 

of what can happen during a pandemic outbreak and what actions you can take to help 

lessen the impact of an influenza pandemic on you and your family. This checklist will 

help you gather the information and resources you may need in case of a flu pandemic.

1. To plan for a pandemic:

Store a two week supply of water and food. During a pandemic, if you cannot get 

to a store, or if stores are out of supplies, it will be important for you to have extra 

supplies on hand. This can be useful in other types of emergencies, such as power 

outages and disasters.

Ask your doctor and insurance company if you can get an extra supply of your 

regular prescription drugs.

Have nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and 

vitamins.

Talk with family members and loved ones about how they would be cared for if they 

got sick, or what will be needed to care for them in your home.

Volunteer with local groups to prepare and assist with emergency response.

Get involved in your community as it works to prepare for an influenza pandemic.

2. To limit the spread of germs and prevent infection:

Teach your children to wash hands frequently with soap and water, and model the 

current behavior.

Teach your children to cover coughs and sneezes with tissues, and be sure to model 

that behavior.

Teach your children to stay away from others as much as possible of they are sick. 

Stay home from work and school if sick.

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A Guide for Individuals and Families 15

3. Items to have on hand for an extended stay at home:

Examples of food and non-perishables

Ready-to-eat canned meats, fish, 

fruits, vegetables, beans, and soups

Protein or fruit bars

Dry cereal or granola

Peanut butter or nuts

Dried Fruit

Crackers

Canned juices

Bottled water

Canned or jarred baby food and 

formula

Pet food

Other nonperishable foods

Examples of medical, health, and 

emergency supplies

Prescribed medical supplies such as 

glucose and blood-pressure monitoring 

equipment

Soap and water, or alcohol-based 

(60-95%) hand wash

Medicines for fever, such as 

acetaminophen or ibuprofen

Thermometer

Anti-diarreal medication

Vitamins

Fluids with electrolytes

Cleansing agent/soap

Flashlight

Batteries

Portable radio

Manual can opener

Garbage bags

Tissues, toilet paper, disposable diapers

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16 www.pandemicflu.gov

Family Emergency Health

 Information Sheet

It is important to think about health issues that could arise if an influenza pandemic 

occurs, and how they could affect you and your loved ones. For example, if a mass 

vaccination clinic is set up in your community, you may need to provide as much 

information as you can about your medical history when you go, especially if you have 

a serious health condition or allergy.

Create a family emergency health plan using this information. Fill in information for 

each family member in the space provided. Like much of the planning for a pandemic, 

this can also help prepare for other emergencies.

1. Family Member Information:

Family Member Blood Type Allergies Past/Current 

Medical 

Conditions 

Current 

Medications/

Dosages
A Guide for Individuals and Families 17

2. Emergency Contacts:

Contacts Name/Phone Number

Local personal emergency contact

Out-of-town personal emergency contact

Hospitals near: Work

 School

 Home

Family physician(s)

State public health department

(See list on www.pandemicflu.gov/

state/statecontacts.html)

Pharmacy

Employer contact and emergency

information

School contact and emergency 

information

Religious/spiritual organization

Veterinarian
18 www.pandemicflu.gov

For More Information

❖ Visit: www.pandemicflu.gov

❖ The Centers for Disease Control and Prevention (CDC) 

hotline, 1-800-CDC-INFO (1-800-232-4636), is available in English and Spanish, 24 hours a day, 7 days a 

week. TTY: 1-888-232-6348. Questions can be emailed 

to inquiry@cdc.gov.

❖ Links to state departments of public health can be 

found at www.pandemicflu.gov/state/statecontacts.

html.