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An influenza pandemic has the potential to cause widespread illness and death. Planning and preparedness before the next pandemic strikes are critical for an effective response. Utah’s Pandemic Influenza Response Plan describes a coordinated strategy to prepare for and respond to an influenza pandemic. Influenza causes seasonal worldwide epidemics of disease that result in an average of 36,000 deaths each year in the United States. A pandemic – or global epidemic – occurs when there is a major change in the influenza virus so that most or all people in the world’s population have no immunity against the virus. Three pandemics occurred during the 20th century; the most severe pandemic (1918) caused over 500,000 deaths in the U.S. and 20-100 million deaths worldwide. Recent outbreaks of human disease caused by avian influenza strains in Asia and Europe have highlighted the potential of new strains to be introduced into the population. An avian influenza (H5N1) virus capable of directly infecting humans was first detected in Hong Kong in 1997. That virus strain has been circulating widely in several Asian countries since 2003. Avian influenza H5N1 has caused 122 human cases and 62 deaths (WHO as of October 24, 2005) and has become enzootic in wild migratory birds. If these strains acquire the ability to be transmitted effectively from person to person a pandemic may occur. Regardless of whether the currently circulating avian influenza (H5N1) strains evolve so as to cause a pandemic or not, history indicates that we will experience another pandemic of influenza sooner or later. Characteristics of an influenza pandemic that must be considered in preparedness and response planning include: 1) simultaneous impacts in communities across the state and the U.S., limiting the ability of any jurisdiction to provide support and assistance to other areas; 2) an overwhelming burden of ill persons requiring hospitalization or outpatient medical care; 3) shortages and delays in the availability of vaccines and antiviral medications; 4) disruption of national and community infrastructures including health care, transportation, commerce, utilities and public safety; and 5) global spread of infection with outbreaks throughout the world. The Utah Department of Health is preparing to effectively respond to the issues mentioned above. This progress has been accomplished through programs specific for influenza as well as programs focused on increasing preparedness for bioterrorism and emerging infectious disease threats. In addition, resources have been allocated to improve statewide influenza surveillance, increase influenza testing capacity at the Utah Public Health Laboratory, assess the need for and potential uses of an antiviral drug stockpile, develop means to deliver vaccine against the pandemic influenza strain once it becomes available, and improve health care system readiness at the community level.