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PubMed2006

Seasonal and pandemic influenza preparedness: science and countermeasures.

Influenza has not been treated with the degree of medical attention that the disease warrants. As such, there is not an adequate baseline of preparedness in the United States to deal with the potential of pandemic influenza. The National Institute of Allergy and Infectious Diseases (NIAID) has been working to enact measures to deal more effectively with a potential influenza pandemic and also to assist in the management of seasonal influenza. The majority of the NIAID's efforts have been dedicated to basic research aimed ultimately at developing and testing, in clinical trials, countermeasures in the form of antiviral drugs and vaccines. Some of the NIAID's current and planned antiviral projects include the (1) assessment of oseltamivir therapy in infants, (2) conduct of clinical trials of higher doses of osteltamivir for avian influenza, (3) appraisal of combination therapies, and (4) evaluation of the next generation of neuraminidase inhibitors. In addition, the NIAID is screening potential new antiviral drugs and evaluating novel drug targets. Similarly, significant funding has been committed to vaccine preparedness, and numerous novel candidate influenza vaccines are in various stages of development. Importantly, there is an integral relationship between preparation for seasonal influenza and preparation for pandemic influenza. Until these approaches are firmly linked, the community will not have optimized its preparedness for a pandemic.

Academies and Institutes↗
PubMedDate not supplied

Hepatitis A in a food worker and subsequent prophylaxis of restaurant patrons.

A laboratory-confirmed case of hepatitis A was reported to Tri-County Health Department (TCHD) in Colorado, and the infected person was subsequently determined to have been a food worker at a local restaurant during the period of infectiousness. After conducting a public health risk assessment, TCHD decided to offer immune globulin (IG) to potentially exposed restaurant patrons. A two-day clinic in Adams County, Colorado, administered IG to 693 individuals. Planning, implementation, and evaluation of this clinic used a total of 900 staff hours and had a financial cost of dollar48,300. No additional restaurant employees became ill, and no secondary cases of hepatitis A were reported within the community. The mass-prophylaxis clinic was an important public health measure taken to prevent the potential spread of illness. The experience also provided relevant hands-on emergency-preparedness training that can be applied in other settings.

Colorado↗
PubMed2004

What have we learnt from SARS?

With outbreaks of infectious disease emerging from animal sources, we have learnt to expect the unexpected. We were, and are, expecting a new influenza A pandemic, but no one predicted the emergence of an unknown coronavirus (CoV) as a deadly human pathogen. Thanks to the preparedness of the international network of influenza researchers and laboratories, the cause of severe acute respiratory syndrome (SARS) was rapidly identified, but there is no complacency over the global or local management of the epidemic in terms of public health logistics. The human population was lucky that only a small proportion of infected persons proved to be highly infectious to others, and that they did not become so before they felt ill. These were the features that helped to make the outbreak containable. The next outbreak of another kind of transmissible disease may well be quite different.

Disease Outbreaks↗
PubMed2006

Avian influenza: risk, preparedness and the roles of public health nurses in Hong Kong.

This paper provides an overview of the Hong Kong government's influenza preparedness plan and the key roles of public health nurses in that plan. The part played by Hong Kong public health nurses in the management of the avian influenza outbreak in Hong Kong in 1997 and the sudden acute respiratory syndrome outbreak in 2003, together with the capacity-building work they are now undertaking in preparing for an influenza pandemic, highlight their crucial role in public health. Recent strengthening of public health infrastructure in Hong Kong and heightened public awareness of public health issues have facilitated more proactive and effective public health nursing activities.

Attitude to Health↗
PubMed2005

Modelling the spread of foot-and-mouth disease in Australia.

Preparedness for an incursion of an exotic animal disease is of key importance to government, industry, producers and the Australian community. An important aspect of Australia's preparedness for a possible incursion of foot-and-mouth disease is investigation into the likely effectiveness and cost-efficiency of eradication strategies when applied to different regional outbreak scenarios. Disease modelling is a tool that can be used to study diseases such as foot-and-mouth disease to better understand potential disease spread and control under different conditions. The Australian Government Department of Agriculture, Fisheries and Forestry has been involved with epidemiologic simulation modelling for more than 10 years, and has developed a sophisticated spatial model for foot-and-mouth disease (AusSpread) that operates within a geographic information system framework. The model accommodates real farm boundary or point-location data, as well as synthesised data based on agricultural census and land use information. The model also allows for interactions between herds or flocks of different animal species and production type, and considers the role that such interactions are likely to play in the epidemiology of a regional outbreak of foot-and-mouth disease. The user can choose mitigations and eradication strategies from those that are currently described in Australia's veterinary emergency plan. The model also allows the user to evaluate the impact of constraints on the availability of resources for mitigations or eradication measures. Outputs include a range of maps and tabulated outbreak statistics describing the geographic extent of the outbreak and its duration, the numbers of affected, slaughtered, and, as relevant, vaccinated herds or flocks, and the cost of control and eradication. Cost-related outputs are based on budgets of the value of stock and the cost of mitigations, each of which can be varied by the user. These outputs are a valuable resource to assist with policy development and disease management.

Animals↗
PubMed2001

The World Trade Center attack. Disaster preparedness: health care is ready, but is the bureaucracy?

When a disaster occurs, it is for governments to provide the leadership, civil defense, security, evacuation, and public welfare. The medical aspects of a disaster account for less than 10% of resource and personnel expenditure. Hospitals and health care provider teams respond to unexpected occurrences such as explosions, earthquakes, floods, fires, war, or the outbreak of an infectious epidemic. In some geographic locations where natural disasters are common, such as earthquakes in Japan, such disaster practice drills are common. In other locations, disaster drills become pro forma and have no similarity to real or even projected and predicted disasters. The World Trade Center disaster on 11 September 2001 provides new information, and points out new threats, new information systems, new communication opportunities, and new detection methodologies. It is time for leaders of medicine to re-examine their approaches to disaster preparedness.

Aircraft↗
PubMed2005

Laboratory exposures to brucellae and implications for bioterrorism.

Brucellae are class 3 organisms and potential agents of bioterrorism. Because of effective public health measures, brucellosis has become a rare disease in industrialized countries, and clinical microbiology laboratories are frequently unfamiliar with the genus. A low index of suspicion by physicians or failure to notify the laboratory, equivocal Gram-stain results, misidentification of the organism by commercial systems, unsafe laboratory practices, and laboratory accidents have been responsible for numerous cases of exposure to the organism and laboratory-acquired disease in recent years. Discovery of a laboratory exposure to brucellae should prompt an exhaustive investigation of the event and its circumstances, definition of the population at risk, enforcement of safe laboratory practices, and antimicrobial drug prophylaxis for exposed persons. Inadvertent exposures to brucellae in the clinical laboratory indicate a widespread lack of preparedness to cope with eventual biologic threats involving use of the organism.

Brucella↗
PubMed2006

Avian influenza.

A rapidly spreading, highly pathogenic avian influenza virus A H5N1 in the domestic poultry population has crossed the species barrier to humans and other mammalian species, thus, posing an increasing pandemic threat. The World Health Organization, other agencies, and countries worldwide are closely monitoring the prevalent influenza viruses and their related illnesses to detect any increased virulence or transmissibility that might signal the beginnings of any future pandemic. So far, the H5N1 virus has infected birds in more than 30 countries in Asia, Europe and Africa, while further geographical spread remains likely. Human infections are still rare and the virus does not spread easily from birds to humans or readily from person to person. Although antiviral drugs and vaccination are among the most important measures to be used in case of an influenza pandemic, a timely supply of sufficient quantities will not be possible. This review describes various aspects of avian influenza in birds and in humans; epidemiology, transmission, diagnosis and clinical manifestations. Also presented are the global preparedness, the anti-influenza drugs and vaccines.

Africa↗
PubMed2006

"Everything depends on good nursing".

Nurses have always played a vital role in the response to outbreaks of deadly illnesses. The story of Alberta nurses' heroic efforts in the face of the Spanish influenza epidemic of 1918-19, in the absence of public health infrastructure, reminds us of the importance of preparedness. The virus, which accompanied soldiers returning from Europe after the First World War, spread quickly along transportation routes from Eastern Canada to the West. Although many nurses had not yet returned from war service, or were assisting in Halifax following the explosion of 1917, those who were available in Alberta vo unteered without hesitation to care for victims of the virus. In the absence of cure, good nursing care was usually the only treatment for the illness. Recognition of the need for planned response to crises, availability of resources and excellent skills and knowledge prompted nursing leaders to lobby the government for a formal public health system and contributed to the organization of professional nursing associations. In the likely event of another global influenza pandemic, nurses may draw upon the lessons of the past as they once again face the complex challenges of a modern health crisis.

Animals↗
PubMed2006

Mass vaccination for annual and pandemic influenza.

Influenza virus causes annual epidemics and occasional pandemics. Frequent mutations in circulating influenza strains ("antigenic drift") result in the need for annual vaccination. More than two-thirds of persons in the U.S. are recommended for annual vaccination. Because influenza vaccine is available seasonally, mass vaccination strategies are well suited to its delivery. Although doctors offices are the most frequent setting for influenza vaccination overall, workplaces, clinics, and community sites (retail stores and pharmacies) also are common vaccination settings. Influenza vaccination also is delivered in mass vaccination clinics to health care workers and military personnel. Universal influenza vaccination, which has been recommended as a strategy to improve prevention by increasing vaccination coverage and providing indirect protection of adults by decreasing infection and transmission among children, would require expanded use of mass vaccination, for example in schools, as well as in the community. Influenza pandemics occur when a new influenza A subtype is introduced into the population ("antigenic shift"). Most or all of the population is susceptible to the pandemic virus and two doses of vaccine may be needed for protection. U.S. pandemic preparedness and response plans indicate that the entire population should be vaccinated beginning with defined priority groups including those who provide essential services including healthcare and those at highest risk of severe illness and death. Pandemic influenza vaccination will occur primarily through the public sector in mass clinic settings. Vaccination program planning must consider issues including coordination, staffing, clinic location and lay-out, security, record keeping, and communications. Exercising vaccination clinics is important for preparedness and can be done in the context of annual influenza vaccination.

Communication↗
PubMedDate not supplied

The threat of communicable diseases following natural disasters: a public health response.

Natural disasters, such as the recent Indian Ocean tsunami, can have a rapid onset, broad impact, and produce many factors that work synergistically to increase the risk of morbidity and mortality caused by communicable diseases. The primary goal of emergency health interventions is to prevent epidemics and improve deteriorating health conditions among the population affected. Morbidity and mortality due to infectious diseases can be minimized providing these intervention efforts are implemented in a timely and coordinated fashion. This article presents a review of some of the major issues relevant to preparedness and response for natural disasters.

Communicable Disease Control↗
PubMed2025

Oropouche Virus Importation in Southern Brazil and Emerging Concern Calling for Enhanced Public Health Surveillance.

Oropouche virus (OROV), an arthropod-borne virus transmitted by Culicoides paraensis, is an endemic arbovirus that historically circulates mostly in the Amazon basin. Between 2022 and 2024, it reemerged as a more widespread public health concern in South America. We conducted a pooled-sample molecular surveillance study to understand the prevalence of Oropouche fever in Brazil's southernmost state. Over 18 months, we analyzed 4060 samples to monitor the virus emergence in the Rio Grande do Sul state. We detected the first human case of OROV in the state, and our phylogenetic reconstruction indicated a travel-related introduction from the Amazon region into Rio Grande do Sul. Despite the absence of local transmission, the invasion of Culicoides paraensis and enzootic circulation of the OROV in Rio Grande do Sul highlight the risk of Oropouche fever outbreaks in the region. We demonstrated that pooled-sample surveillance effectively monitors virus introduction during periods of low endemic circulation, serving as an essential active surveillance tool for the timely detection of virus emergence and enhancing public health preparedness. The multiple introductions of distinct OROV lineages into southern Brazil underscore the importance of genomic surveillance and public health strategies to monitor and mitigate arbovirus spread in the region.

Brazil↗
PubMed2004

Severe acute respiratory syndrome (SARS): the pharmacist's role.

OBJECTIVES: After two outbreaks of severe acute respiratory syndrome (SARS) occurred in Toronto, Ontario, Canada, from March-June 2003, we reviewed the unexpected role and responsibilities of pharmacists during these two crises, and present strategies for better crisis preparedness. METHODS AND RESULTS: Pharmacists were actively involved in battling the SARS crises. After conducting extensive literature searches and evaluations, pharmacists prepared administration and dosing guidelines for the two investigational drugs, ribavirin and interferon alfacon-1, that were being used to treat the syndrome. They provided direct patient care under modified conditions. They revised drug distribution procedures and developed new ones to meet more stringent infection-control standards. Collaborative teamwork with key stakeholders was important in accomplishing tasks in an efficient and timely manner. Regular communication with health care staff took place internally and externally. Education and updated information for pharmacists was crucial. CONCLUSION: Pharmacists can play a vital role during crises in the areas of drug distribution, drug information, and direct patient care. Collaborative teamwork and close communication are keys to success. Pharmacists must be proactive and take a leadership role in assuming pharmacy-related responsibilities. By evaluating what worked and what didn't, pharmacists can develop procedures for future crises requiring pharmacy support.

Anti-Infective Agents↗
PubMed2005

Communicable disease control in a migrant seasonal workers population: a case study in Norway.

Reliable data on the health status of migrant seasonal workers in Europe is scarce. Access to public health care for this population depends on national regulations, and their legal status in host countries. In this manuscript we describe a case study of a salmonellosis outbreak that occurred in Norway, and highlight the difficulties encountered in applying control measures in a population of seasonal migrant farm workers. Surveillance and control of infectious diseases need to be supported by legislation which makes implementation of control measures possible. Efforts have been made to improve the rights for migrants in Europe with regard to healthcare, but seasonal migrant workers still remain largely outsiders where these measures are concerned. Special attention should be given to this disadvantaged group in terms of social rights and healthcare. Preparedness plans should be improved to deal with contagious pathogens involving the seasonal migrant population.

Agricultural Workers' Diseases↗
PubMed1999

Disease prevention and preparedness in cases of animal health emergencies in the Middle East.

The animal health situation in the Middle East is particularly unfavourable, in that this area is significantly exposed to many serious animal diseases. Typical factors which contribute to this situation are illustrated with reference to an outbreak of Rift Valley fever in Egypt from 1977 to 1980. The Middle East is ill prepared to institute disease prevention and control measures, due to deficiencies at both national and regional levels. Early disease detection, diagnosis and reporting must become a priority, both within these countries and among them. The author describes several regional animal health programmes which are supported by international institutions and underlines their respective importance.

Animal Diseases↗