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Influenza Epidemic/ Pandemic
Topic Collection
April 6, 2026

Topic Collection: Influenza Epidemic/ Pandemic

In 2009, the world watched as the pandemic influenza A (H1N1) virus circulated the globe. Many emergency departments, clinics, and physician offices were filled with symptomatic patients and the “worried well” as public health and emergency management agencies modified plans to respond to the evolving pandemic by delivering risk communications to the public, establishing mass vaccination clinics, and distributing personal protective equipment (PPE) and other supplies to protect worker safety. Since that time, the healthcare system has been incorporating lessons learned from the 2009 H1N1 response into continued pandemic influenza planning efforts. New technology in detection, advances in treatment, improved PPE and containment equipment, updated protocols on how to deal with highly infectious diseases, and experience responding to seasonal influenza outbreaks and other large-scale infectious disease outbreaks have all contributed to a more robust capability to respond to the next pandemic. The threats have also grown – an increasing number of novel influenza viruses have demonstrated the ability to occasionally infect humans. The resources included in this Topic Collection can help healthcare professionals and emergency medical planners prepare for the next influenza epidemic or pandemic. It is important to note how important strong healthcare coalitions with tiered response strategies and coordinated incident management are to an effective pandemic influenza response.

ASPR TRACIE has developed several additional Topic Collections with content relevant to specific aspects of epidemic and pandemic influenza planning; they are listed below.

Alternate Care Sites

Coronaviruses (e.g., SARS, MERS and COVID-19)

Crisis Standards of Care

Disaster Ethics

Fatality Management

Healthcare-Related Disaster Legal/Regulatory/Federal Policy

Hospital Surge Capacity and Immediate Bed Availability

Mass Distribution and Dispensing of Medical Countermeasures

Pharmacy

Responder Safety and Health

Virtual Medical Care

 

Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category. 

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Must Reads

ASPR TRACIE. (2019). Healthcare Coalition Influenza Pandemic Checklist. U.S Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This planning tool is intended to assist healthcare coalitions (HCCs) and their partners in assessing their preparedness for an influenza pandemic. It may also be used to orient the response as a pandemic begins. This checklist can help HCCs assess, create, and improve their pandemic preparedness and response plans.
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ASPR TRACIE. (2023). EMS Infectious Disease Playbook.
This playbook (updated in 2023) synthesizes multiple sources of information in a single planning document addressing the full spectrum of infectious agents to create a concise reference resource for emergency medical services (EMS) agencies developing their service policies. The information can be incorporated into agency standard operating procedures and reviewed by the EMS medical director.
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  • Bridget Kanawati Thank you for your interest in this resource. Unfortunately, funding restrictions preclude our being able to provide printed versions of our resources so all of our products, including this one, are only available electronically. ASPR TRACIE Team
    3/26/2020 2:12:42 PM
  • Frances Thorpe I agree with Tracy, is there a way to order this publication in hard copy format? The information contained in this publication highlights agency infection control policies and is a great resource to have in the department library.
    3/26/2020 12:21:37 PM
  • Tracy Miller Is there any way to order a printed and bound version?
    8/9/2018 5:16:09 PM
Bessesen, M., Adams, J., Radonovich, L., and Anderson, J. (2015). Disinfection of Reusable Elastomeric Respirators by Health Care Workers: A Feasibility Study and Development of Standard Operating Procedures. American Journal of Infection Control. 43(6): 629-634.
This article describes a Department of Veterans Affairs feasibility study on the ability of personnel to safely disinfect respirators under pandemic conditions by following standard operating procedures.
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Bui, C., Chughtai, A., Adam, D., and MacIntyre, C. (2017). An Overview of the Epidemiology and Emergence of Influenza A Infection in Humans Over Time. Archives of Public Health. 75:15.
The authors reviewed the epidemiology and emergence of all influenza A serotypes known to cause human infection. They found an increase in recent years in the emergence of avian influenza viruses causing infections in humans and suggest a variety of measures to prevent the emergence of zoonotic disease.
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Centers for Disease Control and Prevention. (2016). Influenza Risk Assessment Tool (IRAT). U.S. Department of Health and Human Services.
This tool was developed by the Centers for Disease Control and Prevention and other influenza experts to assess the risk of a human pandemic emerging from influenza A viruses currently circulating in animals. The IRAT uses 10 weighted evaluation criteria to assess the risk of both emergence and public health impact and to classify each virus as low, moderate, or high risk.
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Centers for Disease Control and Prevention. (2023). Isolation Precautions Guideline. U.S. Department of Health and Human Services.
This document provides infection control guidelines for healthcare settings across the continuum of care. It is intended to inform the development, implementation, and evaluation of infection control and prevention programs in healthcare settings.
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Chest Care of the Critically Ill and Injured During Pandemics and Disasters Panel. (2014). Care of the Critically Ill and Injured During Pandemics and Disasters: Chest Consensus Statement. Chest Journal. 146(4), Supplement:p1S-41S, e1S-e177s.
This supplement to Chest Journal includes several articles composing a consensus statement of the American College of Chest Physicians on the care of the critically ill and injured during pandemics and disasters. Individual articles focus on the following: Introduction and Executive Summary; Methodology; Surge Capacity Principles; Surge Capacity Logistics; Evacuation of the ICU; Triage; Special Populations; System-Level Planning, Coordination, and Communication; Business and Continuity of Operations; Engagement and Education; Legal Preparedness; Ethical Considerations; and Infrastructure and Capacity Building and Response, Recovery, and Research in Resource-Poor Settings.
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Fain, B., Viswanathan, K., and Altevogt, B. (2012). Public Engagement on Facilitating Access to Antiviral Medications and Information in an Influenza Pandemic - Workshop Series Summary. The National Academies of Sciences, Engineering, and Medicine.
This report summarizes a series of workshops on the public’s perception of how to facilitate access to antiviral medication and treatment during an influenza pandemic.
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Los Angeles County Emergency Medical Services Agency. (2010). Recommended Actions for Hospitals to Prepare for and Respond to Pandemic Influenza.
This document provides guidelines to hospitals to prepare for an influenza pandemic. It includes a summary of recommended actions and their triggers, checklists, sample response guides, general background information, and links to additional resources.
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New York City Department of Health and Mental Hygiene. (n.d.). Mystery Patient Drill Toolkit. (Accessed 3/5/2025.)
This toolkit is intended for use by hospital emergency departments, and tests how long it takes for a potential patient with a highly infectious disease to be identified and for staff to begin exposure mitigation procedures; how long it takes for a patient to be transferred to an isolation room; and the capability of the facility to make notifications internally and to the health department. The Toolkit includes scenarios for Ebola Virus Disease, Middle East Respiratory Syndrome, and Measles, but may be modified to suit healthcare facilities of any nature and any type of disease outbreak.
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Saunders-Hastings, P., and Krewski, D. (2016). Reviewing the History of Pandemic Influenza: Understanding Patterns of Emergence and Transmission. Pathogens. 5(4).
The authors review influenza pandemics throughout history to describe the changing knowledge of the virus and efforts to manage outbreaks. Given the unpredictable nature of when the next pandemic will occur, they encourage continued surveillance, coordination, and resource planning to mitigate risks.
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Trust for America's Health. (2009). Pandemic Flu Preparedness: Lessons from the Frontlines.
This report examines early lessons learned by the healthcare system from the response to the 2009 H1N1 pandemic and highlights ongoing concerns about overall U.S. preparedness for potential outbreaks.
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World Health Organization. (2014). Infection Prevention and Control of Epidemic- and Pandemic-Prone Acute Respiratory Infections in Health Care: WHO Guidelines.
This document provides recommendations, best practices and principles for infection prevention and control for acute respiratory infections in health care, particularly those that present as epidemics or pandemics. It includes information on PPE and aerosol-generating procedures. There are also summaries of literature and research reviews on physical interventions for infection control; risk of transmission from aerosol-generating procedures; and effectiveness of vaccination of health care workers to protect patients.
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Antiviral Treatment

Centers for Disease Control and Prevention. (2018). Influenza Antiviral Medications: Summary for Clinicians. U.S. Department of Health and Human Services.
This document provides information on antiviral medications recommended for treatment and chemoprophylaxis of influenza, summarizes influenza antiviral treatment recommendations, identifies treatment considerations for patients hospitalized with suspected or confirmed influenza, describes diagnostic testing for influenza, lists recommended dosage and duration of various antiviral agents for pediatric and adult populations, discusses chemoprophylaxis, and highlights special considerations.
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Avian Influenza

ASPR TRACIE. (2024). Avian Influenza Quick Facts.
This document provides healthcare providers and emergency planners with resource links to improve their readiness for potential human infections with avian influenza A viruses. Users should refer to the websites of the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (APHIS), the Centers for Disease Control and Prevention (CDC), the Food and Agriculture Organization of the United Nations (FAO), and the World Health Organization (WHO) for the most up-to-date information.
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Centers for Disease Control and Prevention. (2024). Highly Pathogenic Avian Influenza A(H5N1) Virus in Animals: Interim Recommendations for Prevention, Monitoring, and Public Health Investigations. U.S. Department of Health and Human Services.
These interim recommendations outline steps for preventing exposure to avian influenza viruses, including recommendations for the public, farmers, workers, clinicians, and state health departments on surveillance and testing. The webpage defines exposure to avian influenza-infected birds, clinical and public health response criteria, information on collecting clinical specimens for testing, influenza antiviral treatment, and avian influenza chemoprophylaxis.
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Li, Y., Linster, M., Mendenhall, I., et al. (2019). Avian Influenza Viruses in Humans: Lessons from Past Outbreaks. British Medical Bulletin. 132(1):81-95.
This article discusses clinical presentation of avian influenza infection, species barriers, susceptibility, and risk factors for human infection. It also contains information on zoonotic avian influenza A viruses, and details on specific subtypes. The authors discuss pandemic mitigation strategies such as close World Health Organization monitoring of select strains, vaccination, antiviral drugs, and the limitations of these measures.
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Lycett, S., Duchatel, F., and Digard, P. (2019). A Brief History of Bird Flu. Philosophical Transactions of the Royal Society B: Biological Sciences. 374(1775):20180257.
This article reviews what is known as of 2018 about avian influenza A and its genetic makeup, from its relationship with the 1918 H1N1 pandemic strain, to epidemics in birds, to zoonoses. The authors describe the virus’s origin, reassortment, and evolution of avian influenza. Finally, the article describes the ongoing risk to human health and how control in domestic bird populations can mitigate the risks.
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Uyeki, T. and Peiris, M. (2019). Novel Avian Influenza A Virus Infections of Humans. Infectious Disease Clinics of North America. 33(4):907-932.
This article discusses symptoms of infection with avian influenza A viruses, characteristics of testing for influenza A virus, and clinical management of influenza A. It provides background on the epidemiology of avian influenza A, exposure risk factors, human-to-human transmission, and pathogenesis.
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Education, Training, and Exercises

* ASPR TRACIE. (2021). Step-by-Step Guide to Implementing the Coalition Infectious Disease Annex TTX Template (PDF).
This guide is part of a toolkit that can help emergency planners create an interactive, discussion-based exercise focusing on impacts to healthcare coalition and healthcare facilities caused by large numbers of patients seeking healthcare following exposure to an infectious agent.
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Department of Emergency Health Services. (2018). Emerging Infectious Diseases Videos for Prehospital Providers. University of Maryland Baltimore County.
This instructional series, comprised of nine modules (listed at the top of the page), includes an introduction to infectious diseases, basic infection control concepts, considerations for personal protective equipment (including donning and doffing), personnel decontamination, patient transport, and transfer of patient care for patients with Ebola and other highly infectious diseases.
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Federal Emergency Management Agency, Center for Domestic Preparedness. (n.d.). Barrier Precautions and Controls for Highly Infectious Disease. (Accessed 9/30/19.)
This is a four-day course for emergency medical services, healthcare, and public health professionals who may triage, transport, and treat those with a highly infectious disease. Training includes guided discussions of best practices, demonstrations, practical experiences, and exercises.
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Illinois Emergency Medical Services for Children. (2010). Use of Strategic National Stockpile [SNS] Ventilators in the Pediatric Patient: Instructional Guidelines with Training Scenarios, 2nd Edition (2010).
These guidelines are intended as a quick reference for just-in-time training and set up of the types of mechanical ventilators included in the Strategic National Stockpile. The guidelines may be used by clinicians with a baseline knowledge of pulmonary physiology and the concepts of ventilation, but who may not be familiar with the stockpiled ventilators or who may not routinely care for children on ventilators.
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* New York City Department of Health and Mental Hygiene. (n.d.). Mystery Patient Drill Toolkit. (Accessed 3/5/2025.)
This toolkit is intended for use by hospital emergency departments, and tests how long it takes for a potential patient with a highly infectious disease to be identified and for staff to begin exposure mitigation procedures; how long it takes for a patient to be transferred to an isolation room; and the capability of the facility to make notifications internally and to the health department. The Toolkit includes scenarios for Ebola Virus Disease, Middle East Respiratory Syndrome, and Measles, but may be modified to suit healthcare facilities of any nature and any type of disease outbreak.
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Epidemiology and Surveillance

* Centers for Disease Control and Prevention. (2016). Influenza Risk Assessment Tool (IRAT). U.S. Department of Health and Human Services.
This tool was developed by the Centers for Disease Control and Prevention and other influenza experts to assess the risk of a human pandemic emerging from influenza A viruses currently circulating in animals. The IRAT uses 10 weighted evaluation criteria to assess the risk of both emergence and public health impact and to classify each virus as low, moderate, or high risk.
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General Information

Chest Care of the Critically Ill and Injured During Pandemics and Disasters Panel. (2014). Care of the Critically Ill and Injured During Pandemics and Disasters: Chest Consensus Statement. Chest Journal. 146(4), Supplement:p1S-41S, e1S-e177s.
This supplement to Chest Journal includes several articles composing a consensus statement of the American College of Chest Physicians on the care of the critically ill and injured during pandemics and disasters. Individual articles focus on the following: Introduction and Executive Summary; Methodology; Surge Capacity Principles; Surge Capacity Logistics; Evacuation of the ICU; Triage; Special Populations; System-Level Planning, Coordination, and Communication; Business and Continuity of Operations; Engagement and Education; Legal Preparedness; Ethical Considerations; and Infrastructure and Capacity Building and Response, Recovery, and Research in Resource-Poor Settings.
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Kash, J. and Taubenberger, J. (2015). The Role of Viral, Host, and Secondary Bacterial Factors in Influenza Pathogenesis. The American Journal of Pathology. 185(6):1528-1536.
The authors provide an overview of influenza and describe the viral, host, and bacterial factors that contribute to more severe illness, complications, and mortality.
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Mina, M. and Klugman, K. (2014). The Role of Influenza in the Severity and Transmission of Respiratory Bacterial Disease. Lancet Respiratory Medicine. 2(9):750-763.
The authors review influenza and respiratory bacterial co-infections, describing the historic understanding of such co-infections, disease dynamics and mechanisms, and prevention and treatment strategies.
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Guidance

Centers for Disease Control and Prevention. (2022). Interim Guidance for Infection Control Within Healthcare Settings When Caring for Confirmed Cases, Probable Cases, and Cases Under Investigation for Infection with Novel Influenza A Viruses Associated with Severe Disease. U.S. Department of Health and Human Services.
This webpage provides guidance on avian influenza A (H7N9), Asian H5N1, and newly detected avian influenza H5 viruses in the U.S.
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Centers for Disease Control and Prevention. (2024). Interim Guidance for Clinicians on Human Infections with Variant Influenza Viruses. U.S. Department of Health and Human Services.
This document provides interim guidance for clinicians on how to identify, diagnose, report, and manage suspect cases of exposure to variant influenza viruses.
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Centers for Disease Control and Prevention. (2024). Interim Guidance for Influenza Outbreak Management in Long-Term Care and Post-Acute Care Facilities. U.S. Department of Health and Human Services.
This webpage provides guidance to long-term care facilities on preventing transmission of influenza through vaccination, testing, infection control, antiviral treatment, and antiviral chemoprophylaxis.
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Various Federal Agencies. (2024). Managing Solid Waste Contaminated with a Category A Infectious Substance.
This guidance document is based on extensive federal interagency coordination and stakeholder input and designed to help those who work in healthcare facilities, medical transportation operations, and laboratories better understand infectious waste and how to manage it.
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Guidelines

Centers for Disease Control and Prevention. (2023). Isolation Precautions Guideline. U.S. Department of Health and Human Services.
This document provides infection control guidelines for healthcare settings across the continuum of care. It is intended to inform the development, implementation, and evaluation of infection control and prevention programs in healthcare settings.
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* National Emerging Special Pathogens Training and Education Center. (2024). EMS Procedural Guidelines for Special Pathogens.
These model procedural guidelines, created by NETEC's EMS/Patient Transport Work Group, are designed to help EMS agencies develop standard operating procedures for the transport and management of patients suspected or confirmed to have a high-consequence infectious disease. The guidelines address personal protective equipment (PPE) donning and doffing, EMS provider down, PPE breaches, biohazard spills, waste management, ambulance modification, and ambulance cleaning and disinfection. They complement ASPR TRACIE's EMS Infectious Disease Playbook (https://files.asprtracie.hhs.gov/documents/aspr-tracie-transport-playbook-508.pdf).
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Non-Pharmaceutical Strategies

Fong, M., Gao, H., Wong, J., et al. (2020). Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings—Social Distancing Measures. Emerging Infectious Diseases. 26(5).
The authors conducted systematic reviews of available evidence on the effectiveness of various social distancing measures in non-healthcare settings in reducing influenza transmission. The measures reviewed were: isolating ill persons, contact tracing, quarantined of those exposed, school dismissals or closures, workplace measures or closures, and avoiding crowding.
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Martinez, D. and Das, T. (2014). Design of Non-Pharmaceutical Intervention Strategies for Pandemic Influenza Outbreaks. BMC Public Health. 14(1328).
The authors modeled various non-pharmaceutical interventions, social behaviors, and their interactions on outcome measures such as numbers of contacts, infections, and deaths to simulate the effects of the strategies on pandemic influenza outbreaks with varying levels of virus transmissibility.
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Xiao, J., Shiu, E., Gao, H., et al. (2020). Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings—Personal Protective and Environmental Measures. Emerging Infectious Diseases. 26(5).
The authors completed systematic reviews of the effectiveness of personal protective and environmental measures in reducing influenza transmission. Measures studied were: hand hygiene, respiratory etiquette, face masks, and surface and object cleaning.
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Personal Protective Equipment and Worker Safety

Bessesen, M., Adams, J., Radonovich, L., and Anderson, J. (2015). Disinfection of Reusable Elastomeric Respirators by Health Care Workers: A Feasibility Study and Development of Standard Operating Procedures. American Journal of Infection Control. 43(6): 629-634.
This article describes a Department of Veterans Affairs feasibility study on the ability of personnel to safely disinfect respirators under pandemic conditions by following standard operating procedures.
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Kilinc, F. (2015). A Review of Isolation Gowns in Healthcare: Fabric and Gown Properties.
The author provides an overview on occupational exposure to emerging infectious diseases in the healthcare industry and the history and use of isolation gowns as personal protective equipment (PPE). As the second-most used type of PPE, the author discusses properties affecting gown performance and factors influencing their design and development.
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Lindsley, W., Martin, S., Thewlis, R., et al. (2015). Effects of Ultraviolet Germicidal Irradiation (UVGI) on N95 Respirator Filtration Performance and Structural Integrity. Journal of Occupational and Environmental Hygiene. 12(8):509-517.
The authors exposed material coupons and straps from four models of N95 filtering facepiece respirators to a range of doses of ultraviolet germicidal irradiation to test particle penetration, flow resistance, bursting strengths of coupon layers, and breaking strength of straps. They found small effects on filtration performance and almost no effect on flow resistance, but a reduction in the strength of respirator materials of more than 90% in some models and a 20-51% reduction in breaking strength of straps. The authors suggest that ultraviolet germicidal irradiation is a possible method to disinfect respirators for reuse, but the respirator model used should first be tested to determine the maximum number of disinfection cycles and the dose required to inactivate the specific pathogen.
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Liverman, C., Domnitz, S., and McCoy, M. (2015). The Use and Effectiveness of Powered Air Purifying Respirators in Health Care: Workshop Summary. The National Academies of Sciences, Engineering, and Medicine.
This report summarizes the proceedings of a workshop examining the current state of practice on the use of powered air purifying respirators in healthcare settings and research on their use and effectiveness.
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National Academies of Sciences, Engineering, and Medicine. (2019). Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. The National Academies Press.
This report examines strategies for and pros and cons related to stockpiling and reusing elastomeric respirators during an influenza pandemic or other large aerosol-transmissible outbreak.
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National Institute for Occupational Safety and Health. (2015). NIOSH Personal Protective Equipment Information (PPE-Info). Centers for Disease Control and Prevention.
This website compiles standards information for personal protective equipment from the U.S. government, American National Standards Institute-accredited standard development organizations, and the International Organization for Standardization. Users can search the database by fields including the category of personal protective equipment, hazard type, standard type, and standard organization.
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Occupational Safety and Health Administration. (n.d.). Respiratory Protection. (Accessed 9/9/2024.) U.S. Department of Labor.
This webpage contains standards on respirators, respiratory protection, and the medical evaluation program.
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Saunders-Hastings, P., Crispo, J., Sikora, L., et al. (2017). Effectiveness of Personal Protective Measures in Reducing Pandemic Influenza Transmission: A Systematic Review and Meta-Analysis. Epidemics.
This meta-analysis examined the effectiveness of hand hygiene, respiratory etiquette, and use of facemasks in reducing the risk of pandemic influenza transmission. The authors did not find data on the effectiveness of respiratory etiquette, but found that hand hygiene was statistically significant and wearing a face mask was suggestive of preventing infection.
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Plans, Tools, and Templates: EMS

* ASPR TRACIE. (2019). Healthcare Coalition Influenza Pandemic Checklist. U.S Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This planning tool is intended to assist healthcare coalitions (HCCs) and their partners in assessing their preparedness for an influenza pandemic. It may also be used to orient the response as a pandemic begins. This checklist can help HCCs assess, create, and improve their pandemic preparedness and response plans.
Favorite:
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ASPR TRACIE. (2023). EMS Infectious Disease Playbook.
This playbook (updated in 2023) synthesizes multiple sources of information in a single planning document addressing the full spectrum of infectious agents to create a concise reference resource for emergency medical services (EMS) agencies developing their service policies. The information can be incorporated into agency standard operating procedures and reviewed by the EMS medical director.
Favorite:
2
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  • Bridget Kanawati Thank you for your interest in this resource. Unfortunately, funding restrictions preclude our being able to provide printed versions of our resources so all of our products, including this one, are only available electronically. ASPR TRACIE Team
    3/26/2020 2:12:42 PM
  • Frances Thorpe I agree with Tracy, is there a way to order this publication in hard copy format? The information contained in this publication highlights agency infection control policies and is a great resource to have in the department library.
    3/26/2020 12:21:37 PM
  • Tracy Miller Is there any way to order a printed and bound version?
    8/9/2018 5:16:09 PM
* National Emerging Special Pathogens Training and Education Center. (2024). EMS Procedural Guidelines for Special Pathogens.
These model procedural guidelines, created by NETEC's EMS/Patient Transport Work Group, are designed to help EMS agencies develop standard operating procedures for the transport and management of patients suspected or confirmed to have a high-consequence infectious disease. The guidelines address personal protective equipment (PPE) donning and doffing, EMS provider down, PPE breaches, biohazard spills, waste management, ambulance modification, and ambulance cleaning and disinfection. They complement ASPR TRACIE's EMS Infectious Disease Playbook (https://files.asprtracie.hhs.gov/documents/aspr-tracie-transport-playbook-508.pdf).
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Plans, Tools, and Templates: Hospitals

* ASPR TRACIE. (2019). Healthcare Coalition Influenza Pandemic Checklist. U.S Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This planning tool is intended to assist healthcare coalitions (HCCs) and their partners in assessing their preparedness for an influenza pandemic. It may also be used to orient the response as a pandemic begins. This checklist can help HCCs assess, create, and improve their pandemic preparedness and response plans.
Favorite:
1
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* ASPR TRACIE. (2021). Step-by-Step Guide to Implementing the Coalition Infectious Disease Annex TTX Template (PDF).
This guide is part of a toolkit that can help emergency planners create an interactive, discussion-based exercise focusing on impacts to healthcare coalition and healthcare facilities caused by large numbers of patients seeking healthcare following exposure to an infectious agent.
Favorite:
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  • This item doesn't have any comments
Minnesota Department of Health, Association for Professionals in Infection Control and Epidemiology - Minnesota, and Health Care Coalitions of Minnesota. (2019). High Consequence Infectious Disease (HCID) Toolbox for Frontline Health Care Facilities.
This toolbox includes a variety of resources to assist frontline facilities in their readiness activities related to patients with high consequence infectious diseases. Included are planning and training tools, exercise templates, and the components (e.g., screening guide, checklists, posters) to create a readiness binder.
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* New York City Department of Health and Mental Hygiene. (n.d.). Mystery Patient Drill Toolkit. (Accessed 3/5/2025.)
This toolkit is intended for use by hospital emergency departments, and tests how long it takes for a potential patient with a highly infectious disease to be identified and for staff to begin exposure mitigation procedures; how long it takes for a patient to be transferred to an isolation room; and the capability of the facility to make notifications internally and to the health department. The Toolkit includes scenarios for Ebola Virus Disease, Middle East Respiratory Syndrome, and Measles, but may be modified to suit healthcare facilities of any nature and any type of disease outbreak.
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New York City Health + Hospitals. (2019). Frontline Hospital Planning Guide: Special Pathogens.
This planning guide from New York City Health + Hospitals provides high-level planning information for frontline hospital multidisciplinary teams to support planning and training for the initial care of suspected special pathogen patients while determining whether and when they will be transferred to another facility for further assessment and treatment.
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Plans, Tools, and Templates: Other

* ASPR TRACIE. (2019). Healthcare Coalition Influenza Pandemic Checklist. U.S Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This planning tool is intended to assist healthcare coalitions (HCCs) and their partners in assessing their preparedness for an influenza pandemic. It may also be used to orient the response as a pandemic begins. This checklist can help HCCs assess, create, and improve their pandemic preparedness and response plans.
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* Centers for Disease Control and Prevention. (2016). Influenza Risk Assessment Tool (IRAT). U.S. Department of Health and Human Services.
This tool was developed by the Centers for Disease Control and Prevention and other influenza experts to assess the risk of a human pandemic emerging from influenza A viruses currently circulating in animals. The IRAT uses 10 weighted evaluation criteria to assess the risk of both emergence and public health impact and to classify each virus as low, moderate, or high risk.
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National Ebola Training and Education Center. (n.d.). NETEC Exercise Templates. (Accessed 9/9/2024.)
This web page includes links to various Homeland Security Exercise and Evaluation Program-compliant templates to assist healthcare coalitions, frontline facilities, assessment hospitals, state-designated Ebola treatment centers, regional Ebola and special pathogen treatment centers, and their respective response partners in the planning and conduct of exercises on the identification, assessment, treatment, management, transport, and transfer of high risk patients. The site includes templates for drills, tabletops, functional, and full-scale exercises. There is also a beginners guide to assist users new to exercise planning.
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Plans, Tools, and Templates: Physician Offices

Centers for Disease Control and Prevention. (2023). Assist in Medical Office Telephone Evaluation of Patients with Possible Influenza for Health Care Settings. U.S. Department of Health and Human Services.
Medical staff can use this flowchart to help triage calls and identify high-risk patients for consideration of initiation of antiviral treatment prior to an office visit.
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Resource Allocation and Management

Koonin, L. and Hanfling, D. (2013). Broadening Access to Medical Care During a Severe Influenza Pandemic: The CDC Nurse Triage Line Project. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. 11(1):75-80.
The authors describe the Centers for Disease Control and Prevention's Nurse Triage Line Project and its goals of using a coordinated network of nurse triage telephone lines during a pandemic to assess the health status of callers, help callers determine the most appropriate site for care, disseminate information, provide clinical advice, and provide access to antiviral medications to those who need it.
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O'Hagan, J., Wong, K., Campbell, A., et al. (2015). Estimating the United States Demand for Influenza Antivirals and the Effect on Severe Influenza Disease during a Potential Pandemic. Clinical Infectious Diseases. 60 (Suppl 1):S30-41.
Following the detection of a novel influenza strain A (H7N9), the authors modeled the use of antiviral treatment in the U.S. to mitigate severe disease across a range of hypothetical pandemic scenarios. The model included estimates of attack rate, healthcare-seeking behavior, prescription rates, and other related data. Based on these inputs, the total antiviral regimens estimated to be available in the U.S. (as of April 2013) were deemed sufficient to meet treatment needs for the scenarios considered.
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Spaulding, A., Radi, D., Macleod, H., et al. (2012). Design and Implementation of a Statewide Influenza Nurse Triage Line in Response to Pandemic H1N1 Influenza. Public Health Reports. 127(5): 532-540.
The Minnesota Department of Health developed several tools to support healthcare providers during the 2009 H1N1 influenza pandemic, including MN FluLine, a nurse triage line, that reached many rural and uninsured residents, and, according to the authors, may have prevented up to 11,000 in-person health-care encounters.
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Vaccines

Centers for Disease Control and Prevention. (2024). Interim Updated Planning Guidance on Allocating and Targeting Pandemic Influenza Vaccine During an Influenza Pandemic. U.S. Department of Health and Human Services.
This document provides guidance on the allocation of influenza vaccine during the early stages of a pandemic when demand may exceed production capacity. It offers general principles on pandemic vaccination and a framework based on targeted groups and pandemic severity.
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  • Sheran Kaplan-Hicks This link is broken and does not provide access to this document.
    10/15/2019 12:32:50 PM
Saunders-Hastings, P., Reisman, J., and Krewski, D. (2015). Assessing the State of Knowledge Regarding the Effectiveness of Interventions to Contain Pandemic Influenza Transmission: A Systematic Review and Narrative Synthesis. PLoS One. 11(12).
This study reviews existing systematic reviews and meta-analyses on pandemic influenza interventions including vaccines, antivirals, personal protective measures, school closures, and traditional Chinese medicine. Pandemic influenza vaccine was found to be protective against infection, but the authors found insufficient evidence for the effectiveness of each of the other interventions in isolation and hypothesized that a combination of interventions would be most effective.
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Agencies and Organizations

Administration for Strategic Preparedness and Response. ASPR's Response to H5N1 Bird Flu.
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Center for Infectious Disease Research and Policy. Pandemic Influenza.
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Centers for Disease Control and Prevention. Information on Bird Flu.
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Centers for Disease Control and Prevention. Influenza.
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Centers for Disease Control and Prevention. Pandemic Influenza.
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Centers for Infectious Disease Research and Policy. Influenza.
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European Centre for Disease Prevention and Control. Avian Influenza.
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Institute for Diseases and Disaster Management. Tools and Resources. NYC Health + Hospitals.
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National Emerging Special Pathogens Training and Education Center.
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National Institute of Allergy and Infectious Diseases. Influenza.
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U.S. Department of Labor, Occupational Safety and Health Administration. Pandemic Influenza.
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World Health Organization. Pandemic Influenza Preparedness (PIP) Framework.
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This ASPR TRACIE Topic Collection was refreshed at the end of 2020. It was comprehensively reviewed in September 2017 by the following subject matter experts (listed in alphabetical order): Eric Alberts, Manager of Emergency Preparedness, Orlando Health; Julie Bulson, DNP, MPA, RN, NE-BC, Director, Emergency Preparedness, Spectrum Health; Matt Gneuhs, Program Manager, Emergency Preparedness and Response, Cincinnati Children’s; Michael Gurnick, Chair, Ashland Branch, Massachusetts MRC Region 4A; John Hick, MD, HHS ASPR, and Hennepin County Medical Center; Jodi Keller, RN, Associate Director of Healthcare System Emergency Preparedness, Central Ohio Trauma System; Lisa Koonin, DrPH, MN, MPH, Deputy Director, Influenza Coordination Unit, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention; Anita Patel, PharmD, MS, Senior Advisor and Lead, Pandemic Medical Care and Countermeasures, Influenza Coordination Unite, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention; Terri Postma, MD, Medical Officer, Centers for Medicare and Medicaid Services; and Mary Russell, EdD, MSN, Emergency Services, Boca Raton Regional Hospital. 

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