The Department of Health and Human Services (HHS) and the U.S. Centers for Disease Control and Prevention (CDC) have issued new guidelines aimed at reducing the impact of a potential pandemic influenza outbreak by improving state, local and community preparedness measures. Released February 2, the guidelines focus on actions to reduce contact between people and slow the spread of illness until vaccines are made available.

The Guidelines include protocols for:

• Voluntary self quarantine. Asking ill persons and their household members to remain at home or not go to work for 7 to 10 days.
• Close schools and child care programs. Reducing contact among kids and teens within the community for up to three months depending on the severity of the outbreak
• Postpone large public gatherings, change workplace environments and shift work schedules without disrupting essential community services.

Recommended actions will vary based on the projected severity of the pandemic. In order to aid decision-making on appropriate actions to take, the new guidelines incorporate a new planning tool, the Pandemic Severity Index (PSI). Similar to the system used to characterize hurricanes for critical government and community response, the PSI has five different categories of pandemics, ranging from "Category 1", a moderate outbreak, to "Category 5", representing the most severe public health crisis.

According to HHS, the new pandemic response guidelines were developed in collaboration with public health officials, researchers and stakeholders from government, academia, private industry, education and civic and faith-based organizations.

For more information from HHS and the CDC on community-based strategies during a pandemic, please go to http://www.pandemicflu.gov/plan/community/community_mitigation.pdf

For information and resources on pandemic flu from the Water Quality & Health Council, please go to http://waterandhealth.org/flu/index.html

A national survey conducted by Rutgers University shows that many U.S. consumers continued to avoid leafy green vegetables months after spinach contaminated with E. coli bacteria killed three people and sickened nearly 200. More than half of the people surveyed who ate spinach prior to the recall had not returned to eating it in November of last year, more than six weeks after the recall ended.

In September, state and federal investigators traced the infected spinach back to California producer Natural Selection Foods, an arm of Earthbound Farms. Among the discussed causes of the contamination were the quality of the water supply used to wash the spinach, as well as fertilization techniques and equipment cleaning practices in processing plants.

Additional findings from the survey include:

• Approximately 9 out of 10 consumers were aware of the spinach recall
• About 20 percent of those who were aware of the recall also stopped eating other bagged produce
• More than 75 percent of survey respondents with spinach in their home threw it out.
• One-third of those surveyed didn't know the recall was over when the poll was taken

According to the Perishables Group, an independent consulting firm to the fresh food industry, through December 23, 2006 sales figures from 16,000 supermarkets showed a 14 percent drop in spinach sales compared to 2005. Additionally, sales of bulk spinach dropped by nearly 50 percent and sales of bagged salad greens that did not contain spinach decreased in by approximately 10 percent.

The sharp decline in spinach sales prompted the produce industry to seek new federal regulations for produce handling to restore consumer confidence in their products.

British authorities destroyed 159,000 thousand turkeys this week in an effort to contain the first farm-based outbreak of the H5N1 strain of bird flu in Britain. The virus was discovered on a farm owned by Europe's largest turkey producer where approximately 2,500 turkeys recently died of the infection. The Department for Environment, Food and Rural Affairs (DEFRA) identified the virus found on the farm as the highly pathogenic Asian strain of H5N1, similar to that found in Hungarian geese during January.

U.K. health officials also announced new restrictions on the movement of birds near the farm where the virus was discovered. In an effort to avoid uncontrolled transmission of the virus, an 806 square-mile restriction zone was set up to isolate all commercial birds from wild birds populations.

European Union food and animal health experts will reportedly meet to discuss the outbreak and review British efforts used to contain the disease.

Bird flu is responsible for the deaths and culling of millions of birds worldwide since 2003 and has killed at least 164 people. British public health officials were quick to announce that there was no immediate danger to human populations from the virus.

For information on bird flu from the CDC, please go to: http://www.cdc.gov/flu/avian/

Last month the United Nations Economic Commission for Europe (UNECE) held its inaugural meeting in Geneva, Switzerland on issues related to preserving and developing access to safe drinking water and basic sanitation for Europeans. Public health representatives from 20 nations met to discuss implementation of various public health programs and public awareness campaigns designed to prevent, control and reduce water-related diseases across the continent.

According to a UNECE spokesperson, over 100 million Europeans remain without access to safe drinking water and proper sanitation.

Programs discussed at the meeting include the creation of performance targets and a reporting structure under the Protocol on Water and Health, water-related disease surveillance and response systems, water supply and climate change adaptation strategies, and the creation of public awareness campaigns.

The spread of diseases transmitted by water is especially common in Eastern Europe, where 16% of the population still does not have access to in-home drinking water systems. According to the World Health Organization, over 170,000 cases of water-related diseases were reported in 2006, including over 120,000 cases of viral hepatitis A, nearly 40,000 cases of Shigella and thousands of cases of enterohaemorrhagic E. coli infection and typhoid fever.

The UNECE reports that the incidence of infectious diseases caused by poor quality drinking water is often highest in children aged 6-11 months.

More information on the UNECE Protocol on Water and Health is available at:
http://www.unece.org/env/water/text/text_protocol.htm.

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