摘要：State, local, tribal, and territorial emergency managers and public health officials must address the specific needs of people with disabilities in their pandemic influenza plans. Evidence from Hurricane Katrina indicated that this population was disproportionately affected by the storm and aftermath. People with disabilities, particularly those who require personal assistance and those who reside in congregate care facilities, may be at increased risk during an influenza pandemic because of disrupted care or the introduction of the virus by their caregivers. Emergency and public health planners must ensure that personal assistance agencies and congregate care operators make provisions for backup staffing and that those who provide critical care are given adequate antiviral drugs and vaccines as they become available. PRIOR TO 1 – 4 AND SINCE 5 , 6 THE events of September 11, 2001, the disability and emergency preparedness communities have demonstrated increasing awareness that the specific needs of people with disabilities are inadequately addressed by emergency planning and response systems. In 2005, concerns further increased during and in the aftermath of Hurricanes Katrina and Rita. People with disabilities experienced inadequate evacuation and shelter, disrupted services, separation from family members and caregivers, and death as a result of poor planning, inadequate risk communication (i.e., instructions on preparing for an emergency, what steps to take should one occur, etc.), and slow response. 7 – 11 After Hurricane Katrina, more than 38% of the shelter residents in Houston, Texas, who had not evacuated New Orleans, Louisiana, before the storm reported that they stayed because they or someone they were caring for was physically unable to leave. 11 Beyond the threat presented to the general population, pandemic influenza poses a substantial risk to people with disability because of (1) a lack of epidemiological data on which to base preparedness plans and evaluate responses; (2) a lack of detailed emergency preparedness plans at all governmental levels with regard to people with disabilities; (3) disability-related factors that increase risk for exposure, complications, and death from pandemic influenza; (4) inaccessibility of risk communication; and (5) ethical issues surrounding priority vaccination and treatments that affect the disability community. We identify the potential needs of persons with disabilities during an influenza pandemic. For each of the challenges, we discuss the status of pandemic influenza planning and present recommendations. We also discuss legislation and regulatory guidelines that promote accessibility of government and private sector services and facilities for people with disabilities.
