The most serious flu pandemic should immediately prompt strict isolation measures, including sending students home from school for up to three months and quarantining households with sick members, according to new federal guidelines issued Thursday.
Because it would take four to six months to prepare a vaccine to protect against a pandemic flu, the guidelines are considered critical to restricting the virus in the interim.
The next best thing to a vaccine "is to try slow down the spread and buy some time," said Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention.
The guidelines were created in part because of continuing concerns over bird flu, which has spread through Asia, Europe, the Middle East and parts of Africa. The virus, which so far rarely infects humans, has not been detected in North America.
The guidelines from the CDC and the Department of Health and Human Services rank the severity of flu epidemics like hurricanes.
The most serious type of outbreak, a Category 5, would be on par with the 1918 Spanish flu pandemic, which killed tens of millions of people worldwide. Such pandemics would call for the most severe measures, including postponing or canceling public gatherings, such as sport and theatrical events; closing child-care centers; and staggering work schedules to thin out crowded offices.
A regular seasonal flu, which has a fatality rate of less than 0.1%, would be a Category 1. The guidelines' only recommendation is that sick people voluntarily stay home until they recover, possibly up to 10 days.
"This seems like a reasonable response," said Dr. David Pegues, a hospital epidemiologist who wrote UCLA Medical Center's pandemic flu plan. "There had not been a threshold in place for when to cancel a hockey game or a Lakers game."
Local health officials would have the ultimate authority to implement the measures, but the CDC recommended that the first cluster of confirmed cases in a state or region trigger a quick reaction.
The definition of a region is intentionally nebulous, said Dr. Marty Cetron, who helped develop the guidelines at the CDC.
"L.A. may be more connected to Hong Kong than some suburban areas," he said. "If there's an epidemic in Hong Kong that feels like an immediate threat, then L.A. officials can consider that a trigger."
Dr. Jonathan Fielding, Los Angeles County's public health director, said guidelines appeared to be appropriately measured.
