Department of Health and Human Services

Pandemic Planning 

Update II

A Report from Secretary Michael O. Leavitt

June 29, 2006

“While pandemics have happened several times in the past, never before 

have we had all of the tools of today. Never before have we possessed 

the wealth of knowledge on the problem and the ability to prepare. The 

challenge is immense, but so is our will to protect and preserve.” 


Last March, I wrote that we are in a race, a race against a fast-moving, highly 

pathogenic avian H5N1 flu virus; a race to prepare in every possible way against a 

potential human flu pandemic. Three months later, the pace has not slackened.

The deadly avian H5N1 virus has now been confirmed in 53 countries, an increase 

of 16 nations since March. Three additional nations have reported human cases. 

The number of reported human cases now stands at 228, an increase of thirty 

percent, and more than half of the people 

infected have died. (please see addendum)

More troubling was a family cluster identified 

in Sumatra, Indonesia. The incident involved 

a fatally ill woman who apparently contracted 

the flu through exposure to poultry and 

who then infected other family members. 

Seven people became ill; six died. All were 

genetically related and had close exposure to 

the initial victim. A World Health Organization 

(WHO) team, including Centers for Disease 

Control and Prevention (CDC) specialist Dr. 

Tim Uyeki, was quickly dispatched to the 

village to test, monitor for further spread of 

the virus, and administer antivirals to people 

potentially exposed. 

Test results released last week revealed that the virus mutated slightly in one of the 

victims, a 10-year old boy, and that the boy passed the virus to his father, who also 

died. Dr. Uyeki says this is the first evidence that a person caught the virus from a 

human and then passed it on to another person. Uyeki stressed that the virus died 

with the father and did not pass outside the family. 

“It stopped. It was dead end at that point,” he said, adding that viruses are always 

slightly changing and there was no reason to raise alarms. It has been more than a 

month since the last death in this family-cluster occurred, and 

no related cases have been identified. 

We continue to learn. Some scientists expected that, by now, 

high-pathogenic H5N1 would have arrived in North America, 

brought here by migratory waterfowl. That hasn’t happened, 

at least not yet. Migratory birds continue to be reservoirs of 

H5N1, but the spread of H5N1 through Western Asia to Europe 

and Africa is now thought to have been caused at least in part 

by the international trade in poultry. We continue to learn how 

much we have to learn.

While the H5N1 avian influenza virus appears to be the greatest 

pandemic threat, there are other strains of concern which we 

must also address. Guided by our five priorities (see box), we 

have accelerated the pace of our planning and preparation. 

Planning summits have been held in all but two states, and almost every state and 

every federal agency has either a draft or final pandemic plan in place. Many states 

are coordinating their strategic plans with neighboring states, and community 

planning is underway across the nation.

Message from the Secretary

Pandemic Preparedness

Five Priorities

• Monitoring disease spread to support rapid 

response

• Developing vaccines and vaccine production 

capacity

• Stockpiling antivirals and other 

countermeasures

• Coordinating federal, state and local 

preparation

• Enhancing outreach and communications 

planning

2003 2004 2005 2006

Through June 24

Countries with H5N1 Avian Influenza and

Human Deaths (both cumulative)

130

53

76

16

35

9

1 3

140

130

120

110

100

90

80

70

60

50

40

30

20

10

0

Countries with H5N1 avian influenza in animals

Human Deaths

(please see addendum)


We took a major step toward building vaccine production capability when, in May, 

we added to previous investments and invested more than $1 billion in the advanced 

development of cell-based vaccine technology. Shifting from the current egg-based 

technology is critical to the ability to quickly produce vast quantities of vaccine 

should a pandemic develop. However, licensed cell-based vaccine production 

in the U.S. is at least several years away.

We continue to stockpile antiviral drugs. The Strategic National Stockpile 

(SNS) now contains sufficient antivirals to treat more than 7 million people. 

An additional 19 million courses of Tamiflu and Relenza are on order, and we 

expect the SNS to contain 26 million courses by the end of 2006. We also 

continue to stockpile N95 respirators (20.2 million on hand) and surgical masks 

(12.3 million on hand).

Information is our friend. When ABC aired its TV drama, Fatal Contact: Bird 

Flu in America, we saw an opportunity to educate people. We prepared a 

viewer’s guide and ABC cooperated by promoting www.pandemicflu.gov at the 

conclusion of the movie. Web site activity immediately following the movie set 

a new record as people sought answers to questions raised by the TV drama. 

The role of the media will be critical should a pandemic develop. Agriculture 

Secretary Mike Johanns and I have been meeting with media executives, 

editors, producers, correspondents, radio talk show hosts and bloggers so 

they know what we know, and so we know what they will need should a 

pandemic threat become imminent. We discussed our mutual roles, asking 

for accurate, responsible reporting and promising to “flood the zone” with the best 

information we have in every form possible. Ultimately, messaging from the federal 

government, in the event of a pandemic, will be coordinated and harmonized with all 

appropriate stakeholders.

These and other developments are detailed below. While we have accomplished 

much in a short period of time, the race we are in is not a sprint, but a marathon. In 

June, Congress passed the President’s FY 2007 emergency funding request of $2.3 

billion to help achieve our pandemic preparedness goals. These funds, the second 

installment of the President’s request, will allow us to continue the essential work 

outlined here. 

As I wrote in my first report, “Preparation is a continuum. Each day we prepare 

brings us closer to being ready. We are better prepared today than we were 

yesterday. And we must be better prepared tomorrow than we are today.”

2004 – H5N1 reference strain created

by reverse genetics from H5N1 virus isolated from Vietnam

April 2005 – RFP for cell-based vaccine contract issued

November 2005 – President Bush announced

the National Strategy for Pandemic Influenza

Summer 2005 – Preliminary results from H5N1

vaccine clinical trials in healthy adults aged 18-64 indicate an

immune response predictive of protection against the H5N1

September 2005 – International Partnership on Avian

and Pandemic Influenza launched

November 2005 – Issuance of HHS 

Pandemic Influenza Plan

November 2005 – WHO Global Meeting

October 2005 – Southeast Asia fact-finding mission 

led by HHS Secretary and State Department

2004 April - November 2005

Message from the Secretary (cont.)

Bandwidth in Mbits/sec

Time

Bandwidth

Pandemicflu.gov site 

activity after TV movie:

Fatal Contact: Bird Flu in America

80

60

40

20

0 8:00 10:00

“Our epidemiological 

investigation did not 

include any other 

plausible source of 

infection except for 

limited human-tohuman transmission 

to explain infection 

in all seven of these 

cases.” 

 –Dr. Tim Uyeki, 

CDC

Referring to the

Indonesia situation.


Early detection is vital to effective preparation for a potential pandemic 

influenza. Should avian H5N1 mutate into a virus easily transmitted from 

human to human, any hope of containing or slowing a pandemic requires 

almost immediate notification and action. Constant international surveillance 

is also critical to determine if the virus mutates again into a new form, which 

affects the development of pre-pandemic vaccines. The goal is to be able to 

detect and respond to an outbreak anywhere in the world within two weeks. 

International Cooperation

The United States has pledged to contribute $334 million to the international 

effort to assist nations most severely affected by bird flu. Funds will be used 

in the detection, containment, and mobilization of resources in areas affected 

by highly pathogenic avian influenza. 

In May, the United States shipped an 

amount of the antiviral drug Tamiflu to 

a secure location in an Asian country. 

The Tamiflu could be used as part of 

the international community’s efforts 

to contain a pandemic. However, if 

containment was not possible, the Tamiflu 

would be sent back to the U.S. stockpile 

of antiviral influenza medications. 

We are working with the WHO, the 

United Nations Food and Agriculture 

Organization (FAO), the World 

Organisation for Animal Health (OIE), the 

Institute Pasteur and concerned national 

governments to closely monitor and 

quickly respond to outbreaks of humans 

infected with avian influenza. 

The CDC is continuing to monitor the situation in Indonesia where, on 

average, one person died of H5N1 every 21⁄2 days in the month of May. 

Working with WHO and local health officials, surveillance and control efforts 

focused on the family-cluster incident (story above) in Sumatra. Daily houseDecember 2005 – Passage of the Public Readiness

and Emergency Preparedness Act (PREP Act)

December 2005 – Enrollment for clinical trials with H5N1

vaccine in healthy adults (>65 years of age) was completed

December 2005 – Convening of States

Summit, in Washington, DC

December 2005 – Release of State and Local

Pandemic Influenza Checklist

December 2005 – Release 

of Business Pandemic 

Influenza Checklist

December 2005 – First State Summit, Minnesota

December 2005 –Tabletop public affairs exercises with 

US Departments and representatives from Canada and the UK

December 2005 –WHO Global Pandemic Communications 

Meeting in Switzerland, HHS led US delegation 

December 2005

Monitoring and Surveillance

H5N1 in wild birds

H5N1 in poultry and wild birds

H5N1 in humans

“They were able to do all 

this [research] working 

with people on a remote 

island in Indonesia. 

What it does is affirm 

that our distant warning 

system has been vastly 

improved.” 

 –Dr. William Schaffner, 

Vanderbilt University

Medical Center


to-house monitoring for influenza-like illness was conducted throughout the 

village and in health care facilities where patients were treated and no further 

related cases were detected. 

Results from the investigation of the cluster revealed that 

the virus mutated slightly in one of the victims, a 10-year 

old boy, and that the boy passed the virus to his father, 

who also died. This is the first documented case where a 

person caught the virus from one human and then passed it 

on to another. Officials stressed that the virus is constantly 

mutating, and that this particular virus died with the father 

and did not pass outside the family cluster. 

Encouraging News

Many lessons have been learned from the world’s swift 

response and containment of infected poultry in Vietnam. 

In 2005, Vietnam experienced 61 cases of H5N1. The 

Vietnamese government worked with the WHO, the 

United States and other countries to contain the problem 

by culling 45 million birds and substantially quelling the 

outbreak. So far, Vietnam has reported no human cases of H5N1 in 2006. 

Similarly, Thailand experienced seven human cases of H5N1 influenza in 2005 

and, through swift containment and bird culling practices, no new cases have 

arisen in 2006. Up to now, the disease appears to be successfully contained 

through culling in Vietnam and Thailand. (please see addendum)

Domestic Monitoring 

Scientists are currently debating the potential role migratory birds have in 

the spread of high-pathogenic avian influenza around the globe. Thus far, 

migratory birds seem to be playing a limited role in the spread of the disease. 

Evidence suggests that migratory birds have not yet spread H5N1 to North 

America as originally predicted. Nonetheless, wild birds are considered to be 

natural reservoirs for all subtypes of avian influenza and prudent monitoring of 

wild birds is crucial to tracking the spread of the disease and disease vectors. 

The Department of Health and Human Services (HHS) is currently working 

with Departments of Agriculture (USDA), Interior (DOI), Homeland Security 

January 2006 – Roughly 5 million courses in SNS stockpile

January 2006 – 6 State Summits AZ,VT, WV, RI, GA, KY

January 2006 – RFI issued on advanced

development of promising antivirals

January 2006 – RFI issued on increasing

egg-based vaccine capacity

January 2006 – Release of

Individuals and Families

Pandemic Influenza Checklist

January 2006 – Bilateral teams sent to Turkey, Armenia, 

Azerbaijan, Georgia, Romania, Ukraine and Nigeria to

assess avian flu outbreaks

January 2006 – International Pledging Conference in Beijing;

$334M in US grants and technical assistance to aid global effort

January 2006 –Tokyo WHO conference to draft WHO pandemic plan

January 2006

Monitoring and Surveillance (cont.)

Map of Indonesia showing 

location of extended family 

cluster of H5N1. 

“As far as we know 

[the mutations] don’t 

correlate with any 

particular functional 

changes about the 

virus. It doesn’t 

confer any greater 

transmissibility or any 

great pathogenicity.” 

 –Dr. Keiji Fukuda, 

WHO


(DHS), the International Association of Fish and Wildlife Agencies (IAFWA) and 

the State of Alaska in an expanded national framework for early detection of 

highly pathogenic avian influenza. 

The expanded early detection network is working closely with local, state 

and federal governments to investigate and monitor live wild birds, mortality 

events of wild birds, birds killed by hunters, backyard poultry flocks and 

environmental samples of water and bird 

feces. Because Alaska is a crossroads of 

migratory bird flyways in North America 

and Asia, it is a priority area for sampling 

of live birds and birds taken in subsistence 

and sport harvests. Sampling in Alaska is 

currently focused on species that migrate to 

and from wintering areas in the Russian Far 

East and Southeast Asia and are thought to 

have the highest probability of contracting the 

virus and bringing it to North America.

Other Developments

CDC has developed FluSurge and FluAid 

(pandemic modeling software) for use by 

communities and hospitals so that they can 

better understand and plan for a potential 

outbreak of a pandemic virus in humans. CDC is continuing to strengthen 

local laboratory capability and its national influenza surveillance system. 

In collaboration with the CDC, the Food and Drug Administration (FDA) 

cleared a new laboratory diagnostic test capable of detecting within hours 

the influenza A/H5 virus that causes influenza A/H5 human infection. In April, 

the FDA provided guidance for industries on diagnostic devices to detect 

influenza A viruses. The guidance provides the in vitro diagnostic industry 

with recommendations for evaluating performance as well as writing product 

labeling that assures safe and effective use of these tests.

January 2006 – First state summit with signing of a 

Planning Agreement, Vermont

February 2006 – 11 State Summits CT, IA, MA, 

FL, OH, NV, DE, AL, MO, NE, MD

February 2006 – Enrollment in a pediatric H5N1 vaccine 

clinical trial (children aged two to nine years) was completed

February 2006 – Laboratory

assay for diagnostic testing of avian

influenza A/H5 approved

January 2006 – Release of Faith-based & Community

Organizations Pandemic Influenza Checklist

January 2006 – Release of School Disricts (K-12)

Pandemic Influenza Checklist

February 2006 – Risk Communications Preparedness

Workshop hosted by CDC in Thailand

February 2006 – Meeting with UN Coordinator for avian

and pandemic influenza on how to best assist UN efforts

Jan 2006 February 2006

Monitoring and Surveillance (cont.)


Vaccination remains a critical defense against pandemic flu. Major efforts 

are underway to increase our ability to produce a vaccine against a pandemic 

virus strain when needed, and work on “pre-pandemic” vaccines continues.

Cell-based Production

Total reliance on egg-based production methods for mass-production of 

a pandemic flu vaccine is a recognized vulnerability, and on May 4, HHS 

invested more than $1 billion in the advanced development of cell-based 

vaccine technologies. Cell-based production of influenza vaccine offers a 

number of significant benefits. 

• In order to produce 300 million doses of vaccine, egg-based production 

would require an estimated 900 million eggs. In the case of an avian flu 

pandemic, egg-producing flocks could decline, jeopardizing vaccine 

production capabilities. 

• While eggs are perishable and must be ordered months ahead of time, 

cell lines can be safely kept frozen indefinitely, increasing the capability to 

rapidly produce vaccines if an influenza pandemic were to occur. 

• Vaccine manufacturers are able to bypass some of the steps needed to 

adapt the virus strains to grow in eggs.

• Certain people allergic to eggs cannot receive vaccines produced from 

chicken eggs, but can be immunized with a cell-based vaccine. 

A total of five contracts were awarded for cell-based vaccine technology 

development: 

• Solvay Pharmaceuticals, $299 million; 

• GlaxoSmithKline (GSK), $275 million; 

• Novartis Vaccines & Diagnostics, $221 million; 

• MedImmune, $170 million; and

• DynPort Vaccine, $41 million. 

Previously, HHS awarded Sanofi Pasteur a $97 million contract for 

development of a cell-based vaccine in April 2005. This company was the first 

March 2006 – 19 State Summits SC, SD, ND, WY, WI, PA, IL,

NC, VA, IN, PR,CO, UT, ID, TX, NM, OR, CA and the Virgin Islands

March 2006 – Results published demonstrated that inactivated 

H5N1 vaccine induces immune responses in healthy adults

March 2006 – Release of Medical Offices and Clinics 

Pandemic Influenza Planning Checklist

March-April 2006 – FDA approves 

Relenza for the prevention of Influenza 

A and B in adults and children

March 2006 – Release of Home Health Care Checklist

March 2006 – Pandemic flu supplemental

guidance sent to states

March 2006

March 2006 – Release of Colleges and Universities ChecklistMarch 2006 – Release of Child Care and Preschool Checklist

March 2006 – RFP issued for advanced

development of antigen sparing technologies

Vaccines and Vaccine Production Capacity

“We will continue our 

essential work to increase 

our domestic capacity 

to produce pandemic 

influenza vaccine and 

antiviral medications.” 

 –Secretary Mike Leavitt


to be awarded a federal contract for commercial scale production of newer 

influenza vaccine methodology.

HHS recognizes the need to also expand the nation’s capacity to produce 

vaccines utilizing traditional egg-based technology. This summer, the 

Department will issue Requests for Proposals (RFPs) for the construction 

of new facilities and/or the expansion or retrofitting of existing facilities. 

HHS has also issued RFPs for antigen-sparing technologies, seeking ways 

to stimulate protection using a smaller amount of vaccine. Contracts for 

antigen-sparing technologies are expected to be awarded this fall.

Vaccine Availability

HHS has stockpiled roughly 8 million doses of vaccine against an H5N1 virus 

strain isolated from Vietnam in early 2004, referred to as the clade 1 virus. 

Given a two-dose vaccination schedule, this would allow vaccination of 

4 million people. Progress has also been made toward development of a 

vaccine against an H5N1 strain isolated from Indonesia in 2005 (clade 2 

virus) that has circulated in Europe, Africa, and parts of Asia. 

While the efficacy of these pre-pandemic vaccines cannot be predicted, 

there is reason to believe they may provide some level of protection for 

priority personnel and those at greatest risk. It is probable that H5N1 

will continue to evolve, making it necessary to continuously evaluate the 

development of pre-pandemic vaccines.

Vaccine Distribution

The Implementation Plan for the National Strategy for Pandemic Influenza, 

released by the Homeland Security Council (HSC) in May, directs HHS to 

coordinate federal efforts to prioritize vaccine allocation during pre-pandemic 

and pandemic periods. HHS has also been directed to coordinate federal 

efforts to list personnel and high-risk groups who should be considered for 

priority access to medical countermeasures. We are currently working closely 

with federal departments and agencies, states and other experts to define 

priority groups for access to pandemic influenza vaccine.

March 2006 –Order of 16.2 million courses of Tamiflu

and 3.9 million courses of Relenza

March 2006 – States receive initial grant funding

for pandemic preparedness

March 2006 April 2006

April 2006 – 7 State Summits TN, AK, WA, HI, LA, MI, 

and the District of Columbia

April 2006 – Government leaders from the

Freely Associated States and Pacific Territories

participate in the Hawaii and Guam summits

April 2006 – Computer model examines strategies to

mitigate potential US flu pandemic

April 2006 – FDA issues guidance for industry on 

diagnostic devices to detect influenza A viruses

April 2006 –WHO issues guidelines

for humanitarian agencies

Vaccines and Vaccine Production Capacity (cont.)

Details of two avian influenza 

A (H5N1) virons, a type of bird 

flu virus, which is a subtype of 

avian influenza A.


Progress continues to be made in developing a national stockpile of antiviral 

drugs that could lessen the impacts of influenza. As of June 1, 2006, the 

Strategic National Stockpile (SNS) contains: 

• approximately 6.2 million regimens of Tamiflu capsules (oseltamivir) with an 

additional 15.4 million on order and expected to arrive through December 

2006.

• approximately 8,600 regimens of Tamiflu oral suspension (oseltamivir). 

• approximately 84,000 regimens of Relenza (zanamivir) with an additional 3.9 

million regimens on order and expected to arrive through December 2006. 

In sum, there will be an approximate stockpile of 26 million antiviral drug 

courses in the SNS by the end of 2006. At least 20 million of these treatment 

courses are to be allocated to states in proportion to population. 

Up to six million courses are reserved for possible opportunities 

to quench isolated outbreaks through community-wide preventive 

administration (mass prophylaxis).

HHS is also enabling states and other entities to purchase up to 

31 million treatment courses of Tamiflu and Relenza at a 25% 

subsidy off the federal contract price. The FY06 HHS budget 

includes $170 million from the supplemental appropriation 

to provide this subsidy. To this end, HHS is finalizing basic 

agreements with Roche and GlaxoSmithKline, respectively, that 

the states may use for subsidized purchases in accord with each 

state’s population.

Antiviral Drug Distribution

States are responsible for the management of the antiviral 

drugs they receive from the SNS. States are required to 

develop distribution plans that cover initial storage, dividing 

the allocation into distribution units, and arranging for delivery of these units 

to the organizations responsible for local distribution of the drugs. HHS, in 

collaboration with the Healthcare Distribution Management Association, is 

developing a model distribution plan to help states with their planning that 

utilizes existing private infrastructure for the distribution of antivirals and other 

supplies.

May 2006 – HHS awards contracts totaling more

than $1 billion to develop cell-based influenza vaccine

May 2006 –Release of National Strategy for Pandemic

Influenza: Implementation Plan

April 2006 May 2006

May 2006 – Department of State establishes Avian

Influenza Action Group to coordinate US international effort

May 2006 – Release of Long-Term Care and

Other Residential Facilities Checklist

April 2006 – NIH researchers discover interregional 

spread of influenza through United States as described

by virus type, size of population and commuting rates and distance

April 2006 – HHS Assistant Secretary Simonson travels

to Bangladesh and India to enhance planning for a

potential influenza pandemic

Antiviral Drugs

Antiviral Stockpile

12/08 81 million courses 

12/06 26 million courses 

03/06 20 million courses

 6 million courses*

* a course is the number of doses needed to treat one person

On

Hand

ordered
10

First-defense Deployment

One strategy for containing or slowing the spread of a pandemic virus calls 

for the administration of Tamiflu to patients and their close contacts as well as 

to people in the area surrounding an initial outbreak. As noted above, Tamiflu 

was supplied to people in contact with the family cluster in Indonesia. In May, 

HHS sent a stockpile of Tamiflu to Asia to be pre-positioned for first defense 

containment efforts in the event of a pandemic flu outbreak. 

Stockpiling Other Supplies

HHS will spend $162 million to procure essential medical supplies for dealing 

with a pandemic. Planned purchases in 2006 include 6000 ventilators, 100 

million N95 respirators, and 50 million surgical masks as well as face shields, 

gowns and gloves. To date, 20.2 million respirators have been stockpiled with 

another 87.2 million on order through September 2007 and 12.3 million surgical 

masks are on hand with another 39.2 million on order through September 2006.

State and local preparedness is crucial to pandemic readiness. An influenza 

pandemic will likely occur simultaneously or in waves across every community 

in our nation. All functions of society could potentially be disrupted by a 

pandemic. Every level of our communities must be prepared to be self-sufficient 

in the event of a pandemic outbreak. 

Congress allocated $350 million this year to assist with state and local 

preparedness. Of this, $100 million has been allocated to states to begin 

their planning process by identifying gaps in preparedness. States are now 

submitting applications for how they will spend the remaining $250 million. The 

plans are expected to cover three areas:

• Prioritize the gaps identified in an earlier funding application and propose a 

work plan to address them,

• Develop a distribution plan for antivirals, and

May 2006 – 7 State Summits MS, OK, NJ, KS, NH, MT, and 

Tribal Leaders

June 2006 – Secretaries Leavitt of HHS and Johanns of

USDA hold national briefing with print, wire, broadcast and 

news media outlets on US preparations for avian influenza

May 2006 – Congressional Budget Office report on

possible macroeconomic effects and policy issues in 

preparation of potential influenza pandemic

May 2006 June 2006

June 2006 – HHS Secretary addresses health ministers of 

Central America on pandemic preparedness

June 2006 – CDC issues updated 

Interim Guidance for Laboratory 

Testing of Persons with Suspected 

Infection with Avian Influenza A 

(H5N1) virus in the US

May 2006 – HHS Secretary addresses the WHO on pandemic flu

preparedness

Antiviral Drugs (cont.)

State and Local Preparedness

“If this happens, 

it’s not going to be 

business as usual. If it’s 

a pandemic, it’s going 

to affect the entire 

world. We can’t look 

for outside help.” 

 –Fire Chief Bob

Painter, 

Homer, Alaska
11

June 2006 – USAID announces $5 million award to

enhance international efforts to track avian influenza

June 2006 – USDA trains foreign scientists on avian

influenza diagnostic testing

July 2006 – New York City Summit

June 2006 July 2006

June 2006 – Congress passes $2.3 billion funding for 

pandemic preparedness

August -September 2006 – 

Contract awards expected on

advanced development of

promising antivirals

Aug-Sep 2006

June 2006 – Indonesia holds avian influenza expert

consultation

• Design a full-scale state/local pandemic influenza response exercise.

We have convened state summits in all but two states, and the remaining two 

summits are now scheduled. Summits have also been held in Puerto Rico and 

the Caribbean and Pacific territories, and with Tribal leaders. In 

each state, the governor, state, local and federal officials and 

members of the community have come together to strategize 

planning for a potential influenza pandemic. Most states have 

worked with HHS to complete a planning agreement detailing 

shared and independent responsibilities for pandemic planning.

Many states have already carried the planning process to 

the next level, holding regional, cross-state and community 

pandemic planning meetings. West Virginia organized 

seven regional pandemic flu summits with members of local 

communities. Rhode Island is hosting a cross-state pandemic 

planning meeting with New York, Maine, Connecticut, 

Massachusetts, New Hampshire, and Vermont. Many other 

states are also coordinating their strategic plans with neighboring states. 

This fall, HHS will begin holding risk communications training sessions for state 

and local public health professionals and community leaders in each of the 

ten HHS regions. Tabletop exercises will also be held, testing both planning 

and training by having officials interact through scripted scenarios. States are 

already submitting proposals detailing state pandemic planning exercises. State 

by state, we are moving from awareness to preparedness.

Communications is at the heart of our planning. The free and rapid flow of 

information both domestically and internationally is critical to everything from 

education to decision making.

All communications materials, from fact sheets to checklists, from text to video, 

are made available 24/7 to a world wide audience via www.pandemicflu.gov. 

State and Local Preparedness (cont.)

The Minnesota Department 

of Health followed its 

summit by holding a TV 

call-in show, during which 

12 public health and public 

safety experts answered 

more than 200 calls from 

citizens who wanted more 

information about bird flu 

and pandemic flu.

Communications
12

Our cross-government Web site is growing exponentially, with content 

increasing more than 25 percent in the past three months alone. 

Highlights include the addition of a question & answer database, additional 

checklists, an updated Guide for Individuals and Families and the translation 

of key documents into Spanish. With crossgovernment content ownership, a coordination 

council meets regularly to insure that information is 

current, consistent and coordinated across all related 

pages.

Over the last several months, we’ve held roundtable 

discussions on avian and pandemic flu with the 

major broadcast and cable television networks and 

national wire services. Reporters, producers and 

media executives were told of government planning 

efforts. 

Discussion explored how the government and 

media would act and interact in different H5N1 

scenarios. Growing out of these discussions, plans 

are now being drafted to conduct a tabletop exercise 

involving the media and health officials in a mock 

pandemic flu situation. 

Broadcasters stressed their need for video content, and HHS plans to meet that 

need by building a library of video interviews and footage. Broadcast facilities 

in Washington and at CDC in Atlanta are being upgraded to expand emergency 

broadcast capabilities. Convergence technologies will allow video content to be 

webcast directly to the public.

We are working to communicate to all the peoples of the world the essential 

information they need to plan, prepare and ultimately cope with pandemic flu 

and its impacts. The WHO has modeled its draft communications operational 

plan on the HHS plan. Since March, we have supported or provided risk 

communications training for ministry of health communicators from twelve 

nations, and in April, HHS met with its Canadian and Mexican counterparts to 

coordinate communications in an open, timely and transparent manner. 

Federal Preparedness

A response to a pandemic will require national coordination. HHS is only one of 

many federal departments and agencies that are taking preparatory measures 

to ensure that they can adequately support state and local officials in the event 

of an outbreak. Working with the DHS, USDA, the White House, and our other 

federal partners, HHS will utilize the multi-agency coordinating structures of 

the National Response Plan should an outbreak require a synchronized federal 

response.

Communications (cont.)

Available Checklists:

Upcoming Checklists:

Law Enforcement

Health Insurers

Travel Industry

Correctional Facilities

� State and Local

Individuals and Families

Business

Schools 

Faith-based and Community Organizations

Medical Offices and Clinics

Home Health Services

Long-Term Care and Other 

Residential Facilities

Emergency Medical Services

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13

Since this report was published in June 2006 there are new developments 

detailed below:

Page 2, paragraph 2 and chart:

On August 8, 2006, the World Health Organization (WHO) confirmed that China 

retroactively reported a fatal H5N1 human case for 2003. This increases the 

number of human cases at the time of publication to 229. The chart should 

also reflect this increase with four human H5N1 deaths in 2003.

Page 5, paragraph 2:

On July 26, 2006, the World Health Organization reported a new case of H5N1 

in humans in Thailand.

Addendum