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Section 4 4-38 Ramsey County Multijurisdictional Hazard Mitigation Plan | July 2012 by influenza each year in the United States. The continuous genetic changes in the virus, called “antigenic drift,” means that people can get sick from a slightly different influenza virus each year; last year’s flu shot does not prevent this year’s illness. Historians estimate that over the last three centuries, there have been 10 influenza pandemics. A pandemic is an epidemic that affects the entire world. Influenza pandemics occur when the virus undergoes such dramatic changes that virtually no one has resistance to infection and there is no vaccine readily available for use. When this occurs, the number of people infected is much higher than during ordinary flu seasons. In addition, during some pandemics, the severity of illness is higher. For example, in 1918–1919, not only was the number of ill people high, but also the death rate was 50 times higher than usual. Furthermore, there was a shift in the age group most severely affected from the elderly to those 20– 40 years of age. In contrast, the more recent pandemics of 1957 and 1968 caused far less dramatic increases in the death rate (only about two times the norm of 36,000 per year from regular flu). The H1N1 novel influenza virus rapidly established itself as a pandemic in 2009–2010, becoming the dominant influenza strain in most parts of the world. The current influenza vaccine includes this strain of virus and protects against H1N1. The outbreak of the H5N1 influenza strain (bird flu) in wild and domestic birds, which began in Asia in late 2003, is being carefully watched as a potential precursor to a pandemic since several hundred humans have been infected and died. Although the number of human infections is quite small, about 60 percent of those infected have died, demonstrating the severity of this infection. The conditions to trigger a pandemic are not yet present since, at this point, the H5N1 virus is not efficiently transmitted from human to human. Vulnerability Assessment All populations within Ramsey County are susceptible to epidemic/pandemic events that occur in the County. Assets Exposed to Hazard  Property Risk/Vulnerability: It was determined that all critical facilities as well as all public, private, and commercial properties are susceptible to being affected by a epidemic/pandemic incident due to people being ill and possibly being unable to maintain the facilities.  People Risk/Vulnerability: In evaluating vulnerability of the population in Ramsey County, it was determined that risk/vulnerability includes the entire population of Ramsey County since there is no way to determine the impact/magnitude of an epidemic/pandemic incident and no way to predict which target group(s) will be the most susceptible to the virus. In addition to sickness (morbidity) and death (mortality), the impact of human resources would suffer with the potential of 40 percent of the workforce becoming ill. Ramsey County’s current just-in-time economy would suffer major setbacks in community infrastructure such as public water supply, food, trucking, health care delivery, and energy resources.  Environment Risk/Vulnerability: Risks to the environment are low should an epidemic/pandemic incident occur. Damage Assessment Although pandemics/epidemics like polio and plague have largely been eradicated from the world and tuberculosis is under control in the United States, past historical complications on human health were devastating and any new infectious diseases introduced to the world could have health emergency implications. Recent SARS, H1N1, and seasonal influenza cases demonstrate that health emergencies are unpredictable, can erupt quickly, and have significant impact on communities, including Ramsey County.