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PubMed2004

Hospital preparedness and SARS.

On May 23, 2003, Toronto experienced the second phase of a severe acute respiratory syndrome (SARS) outbreak. Ninety cases were confirmed, and >620 potential cases were managed. More than 9,000 persons had contact with confirmed or potential case-patients; many required quarantine. The main hospital involved during the second outbreak was North York General Hospital. We review this hospital's response to, and management of, this outbreak, including such factors as building preparation and engineering, personnel, departmental workload, policies and documentation, infection control, personal protective equipment, training and education, public health, management and administration, follow-up of SARS patients, and psychological and psychosocial management and research. We also make recommendations for other institutions to prepare for future outbreaks, regardless of their origin.

Canada↗
PubMed2006

Influenza and the pandemic threat.

With the increasing concern of an imminent influenza pandemic, Singapore and many other countries have been developing preparedness plans. Influenza affects an estimated 20 percent of the population of Singapore annually, and local outbreaks can last for more than 12 weeks and occur at different periods of the year. The 1968 pandemic in Singapore had a clinical attack rate of about 20 percent and resulted in infections with fever that lasted up to five days. However, absenteeism from work due to seasonal influenza-like illnesses was estimated to be less than one day per person in Singapore. The next pandemic in Singapore is predicted to cause an average of 1,105 deaths and 3,338 hospitalisations, while a severe pandemic will cause more healthcare damage. Preventive strategies include national public health initiatives, vaccination, anti-viral therapy, and hygiene measures. To develop effective preparedness plans, it is important for healthcare workers to understand the disease's epidemiology, outcomes, and treatment and prevention strategies available.

Antiviral Agents↗
PubMed1991

Epidemic keratoconjunctivitis at a U.S. military base: Republic of the Philippines.

Between August 1988 and January 1989, 2,603 cases of acute conjunctivitis occurred at Clark Air Base in the Philippines. Clinical features of the disease were consistent with epidemic keratoconjunctivitis. Adenovirus types 19 and 8, as well as enteroviruses, were isolated from conjunctival swabs. Approximately 18% of 9,167 active duty personnel were affected. In an attempt to contain the outbreak, active cases were isolated from the workplace, resulting in 9,038 personnel-days lost. Military preparedness was significantly impacted. A case-control study revealed multiple risk factors for acquisition of the disease.

Adenovirus Infections, Human↗
PubMed2002

Threat of a biological terrorist attack on the US food supply: the CDC perspective.

Deliberate contamination of food with biological agents has already been perpetrated in the USA. The US food supply is increasingly characterised by centralised production and wide distribution of products. Deliberate contamination of a commercial food product could cause an outbreak of disease, with many illnesses dispersed over wide geographical areas. Dependent on the biological agent and contaminated food, such an outbreak could either present as a slow, diffuse, and initially unremarkable increase in sporadic cases, or as an explosive epidemic suddenly producing many illnesses. Preparedness for a bioterrorist event affecting the food supply, therefore, entails augmentation of the traditional public-health infrastructure to enhance disease surveillance, accelerate capacity of laboratory detection, rapidly investigate and control outbreaks, and develop capacity for response to mass-casualty disasters.

Bioterrorism↗
PubMed2006

[Preparedness and international contribution on H5N1 highly pathogenic avian influenza and pandemic-influenza].

Since the end of 2003, simultaneous outbreaks caused by H5N1 highly pathogenic avian influenza viruses (H5N1-HPAIV) occurred in poultries and in wild birds in the East Asia. The outbreaks are spreading now at least 48 countries in the Middle Eastern, African and European countries in addition to the East Asia. During the outbreaks, over 200 human infection cases with 55% fatality are confirmed at the moment and some human-to-human transmission in family clusters have been observed. The outbreaks are no more out of control and pandemic potential caused by H5N1-HPAIV is major concern. Therefore, it is urgently necessary to develop new diagnostic kits and effective vaccines and to stockpile anti-influenza drugs before pandemic alert period phase 4 defined by WHO. Furthermore, international supports to the affected countries for development and improvement of diagnostic system are required in the public health aspect.

Animals↗
PubMed2026

Bundibugyo at the border: The 2026 Ebola outbreak and the case for pre-emptive countermeasure equity.

The 2026 Ebola outbreak caused by Bundibugyo ebolavirus in the Democratic Republic of the Congo and Uganda exposes a persistent structural flaw in global health security: preparedness remains overwhelmingly reactive and pathogen-specific. Despite the $518 million Africa CDC-WHO joint continental plan, no licensed BDBV vaccine or therapeutic is available; a 21-day (three-week) detection delay and cross-border transmission expose inadequate inter-epidemic investment in non-Zaire ebolavirus countermeasures. We argue for sustained, ring-fenced financing, institutionalised cross-border coordination, species-inclusive diagnostics, and real-time genomic data sharing to move African Ebola preparedness from reactive to pre-emptive.

Hemorrhagic Fever, Ebola↗
PubMed2006

Emergence of chikungunya virus in Indian subcontinent after 32 years: A review.

An outbreak of chikungunya virus is currently ongoing in many countries in Indian Ocean since January 2005. The current outbreak appears to be the most severe and one of the biggest outbreaks caused by this virus. India, where this virus was last reported in 1973, is also amongst affected countries. Chikungunya virus has affected millions of the people in Africa and Southeast Asia, since it was first reported in 1952 in Tanzania. Even then, natural history of this disease is not fully understood. The intra-outbreak studies, point towards recent changes in the viral genome facilitating the rapid spread and enhanced pathogenecity. The available published scientific literature on chikungunya virus was searched to understand the natural history of this disease, reasons for the current outbreak and the causes behind re-emergence of the virus in India. The paucity of the scientific information on various epidemiological aspects of chikungunya virus threatens off an epidemic as control of spread of virus might be difficult in the absence of appropriate knowledge. There is an immediate need of the research on chikungunya virus, for an effective vaccine besides strengthening the existing diagnostic laboratory facilities. The current outbreak can also be taken as a lesson for establishment of a system for continuous surveillance of diseases, considered disappeared from the countries. The re-emergence and epidemics are unpredictable phenomena but the impact of such events can be ameliorated by appropriate knowledge and by being in the right state of preparedness.

Aedes↗
PubMedDate not supplied

Outbreak investigations: Community participation and role of community and public health nurses.

Community and public health nurses (C/PHNs) may play a vital role in the investigation of disease outbreaks. C/PHNs possess skills in conducting interviews on sensitive subjects and in collaborating with communities. C/PHNs maintain key links to community providers, symptomatic clients, their families and associates, as well as community institutions where outbreaks occur. This combination of skills makes C/PHNs ideally suited to perform outbreak investigations. There are, however, pressing questions about whether C/PHNs are adequately prepared to contribute to investigation outcomes, to foster participation of affected communities, and to fully apply nursing skills to outbreak investigations to stop the spread of disease. Using one case study, the authors explore investigation outcomes, community participation issues, educational preparation, and public health funding and workforce policies required to achieve these ends successfully. One model of community participation in the steps of outbreak investigation and several Quad Council domains and competencies are proposed for use in practice. Questions regarding the use of emergency preparedness funding and employment of C/PHNs in epidemiology roles are raised.

Caliciviridae Infections↗
PubMedDate not supplied

Preparing for the unknown, responding to the known: communities and public health preparedness.

More than four years after September 11, 2001, bioterrorism preparedness remains a high priority for federal, state, and local governments. With reasonably flexible federal funding, communities have strengthened their ability to respond to public health emergencies, according to assessments by stakeholders and market observers. Collaborative relationships developed for bioterrorism preparedness have proved useful in addressing other threats, such as natural disasters and infectious disease outbreaks. Major ongoing challenges include funding constraints, inadequate surge capacity, public health workforce shortages, competing priorities, and jurisdictional issues.

Bioterrorism↗
PubMed1999

Animal health emergencies: prevention and preparedness in Asia.

Besides response and recovery, prevention and preparedness are the two critical components of any contingency plan. The author discusses the various elements which must be present in the prevention and preparedness plan of countries in Asia. As the continent has such diverse peoples and veterinary infrastructures, the actual plan may vary from one country to another, but must incorporate those elements which are crucial to ensure the success of the preparedness plan.

Animal Diseases↗