Pandemic Influenza Preparedness and Response Plan for Miami-Dade County, Florida

The Miami-Dade County Health Department has joined the international and national community in planning for increased and sustained human-to-human transmission of a novel influenza virus subtype, such as H5N1 in Miami-Dade County. Miami-Dade County has identified 7 areas of concentration for planning and response activities related to pandemic influenza. These are: planning and preparation; threat identification and assessment; official notifications; local health department and emergency operations center activation; disease containment; vaccine and antiviral medication distribution and use; and recovery following a first pandemic wave.

The world experienced three influenza pandemics in the 20th century, each ranging in intensity and number affected from 700 thousand worldwide deaths in 1968 to an unprecedented 50 million in 1918. Seasonal influenza, which is caused by one of three known A subtypes of influenza viruses (H1N1, H1N2 and H3N2) does not result in pandemic-level outbreaks due to prior human exposure and vaccine availability. On average, 36,000 people die each year in the United States from influenza. A pandemic only occurs when a new infectious disease for which humans have little or no immunity emerges, rapidly spreads from human to human and causes serious illness. A 1918-like pandemic influenza event (50 million deaths worldwide) is the contextual framework for Miami-Dade County’s plan, while lesser degrees of impact will have relevance to modified response activities.

The number of people who become ill from a disease divided by the total number of people exposed and multiplied by 100 is referred to as an attack rate. Miami-Dade County has planned for an attack rate of 35% translating into 35% of the county’s total population (over 2.4 million) becoming ill, nearly 10% of the ill hospitalized and 2.3% dying from serious illness. Pandemic Influenza Related Illnesses, Hospitalizations and Deaths.

The World Health Organization (WHO) established six pandemic phases to define the level of international risk for pandemic influenza, ranging from Phase 1 (low risk of human cases) to Phase 6 (efficient and sustained human-to-human transmission). The world has been at Phase 3 since November 2005 when human infection(s) with a new influenza virus subtype (with no or very limited human-to-human transmission) was detected. The Florida Department of Health (FDOH) has established WHO Sub-Phases which provide greater specificity for pandemic activity within the State of Florida. In the event of an influenza pandemic impacting the State of Florida, the Miami-Dade County Health Department will follow the state’s WHO Sub-Phases for its surveillance, activation and response activities. Federal guidelines issued by the U.S. Department of Health and Human Services for prioritization of antiviral medications and vaccines will be followed by Miami-Dade County.

As of June 2007, the Miami-Dade County Health Department (Department) will assume all Emergency Support Function-8 (Health & Medical) responsibilities in Miami-Dade County, Florida. It is the responsibility of ESF-8 to plan for, mobilize, and manage health and medical services during the response and recovery phases of a disaster, as specified in the Miami-Dade County Comprehensive Emergency Management Plan, and will operate as part of the Human Services Branch under the Operations Section Chief. The Pandemic Influenza and Response Plan for Miami-Dade County offers planning guidance through on-line pull-down menu features for consideration and implementation by local government and non-government essential service providers, health and medical institutions, local and state partners, educational systems, overseers of community gathering places and businesses. 

Cities Readiness Initiative

Working in collaboration with the Miami-Dade County Health Department and Miami-Dade County Office of Emergency Management, the Council was the lead planner for the 2005/2006 Cities Readiness Initiative (CRI), a federal bio-preparedness program. The goal of CRI was to develop unified Federal, State and Local plans that offer guidance for responding immediately following a catastrophic event. The Centers for Disease Control & Prevention selected Miami-Dade County, together with 20 other cities and the District of Columbia to help craft best practices and response plans. The ultimate task was to aid communities in increasing their capacity to deliver needed medications and medical supplies to the public during a large-scale public health emergency such as a widespread outbreak of anthrax, smallpox or botulism, arising from an attack of bioterrorism or a major disease outbreak.