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At least 1,297 records · Page 72Linked to original sources
PubMed2003

Factors contributing to the occurrence of emerging infectious diseases.

Emerging infectious diseases (EIDs) have been receiving increasing attention for more than two decades. Such attention has resulted from observations of increasing resistance of microorganisms to the usual antibiotics, the identification of formerly unknown disease agents and the diseases they cause, and the realization that the concept of globalization includes global exposure to disease agents formerly confined to small, endemic, or remote areas. Sadly, in the fall of 2001, the potential for using microbial agents as instruments of terror and destruction became obvious with the incidents of anthrax spread in the United States, mainly through the mail, although chemical and biological agents had already been used in this way in the past century. The relationship between infectious diseases and social, political, and economic change from the earliest times to the present has been well documented. Emerging infectious diseases and their basic causes present a threat to the stability of nations and indeed the world. Reasons for the emergence/reemergence of infectious diseases are complex and interrelated. The global village provides global economic and social opportunities but also opportunities for disease emergence and transmission. Although characteristics of microorganisms such as genetic adaptive changes are important in the emergence of infectious diseases, factors under human control play a large role. Behavioral and lifestyle choices are also a major influence on the emergence and spread of many EIDs and require attention. Factors contributing to the appearance of emerging and reemerging infectious diseases are discussed.

Bioterrorism↗
PubMedDate not supplied

The international trade in toxic waste: the case of Sihanoukville, Cambodia.

In December 1998, 2,700 metric tons of industrial waste containing high levels of mercury and other metals and possibly other toxic compounds were shipped illegally from Taiwan to Sihanoukville, Cambodia. There the waste was unloaded and transferred to a nearby inland dumpsite. An estimated 2,000 Sihanoukville residents were exposed to the waste occupationally or environmentally, and at least six deaths and hundreds of injuries have been associated with the incident. The authors describe the human exposures and associated morbidity and mortality, recount the medical and public health response, and consider the issues complicating epidemiologic analysis of the incident. They also consider the major issues highlighted by the incident, including the trade in toxic waste between developed and less developed countries, the factors that shape emergency public health responses in resource-poor environments, and the importance of prevention and preparedness in containing emergencies in developing countries.

Adult↗
PubMed2006

Business and public health collaboration for emergency preparedness in Georgia: a case study.

BACKGROUND: Governments may be overwhelmed by a large-scale public health emergency, such as a massive bioterrorist attack or natural disaster, requiring collaboration with businesses and other community partners to respond effectively. In Georgia, public health officials and members of the Business Executives for National Security have successfully collaborated to develop and test procedures for dispensing medications from the Strategic National Stockpile. Lessons learned from this collaboration should be useful to other public health and business leaders interested in developing similar partnerships. METHODS: The authors conducted a case study based on interviews with 26 government, business, and academic participants in this collaboration. RESULTS: The partnership is based on shared objectives to protect public health and assure community cohesion in the wake of a large-scale disaster, on the recognition that acting alone neither public health agencies nor businesses are likely to manage such a response successfully, and on the realization that business and community continuity are intertwined. The partnership has required participants to acknowledge and address multiple challenges, including differences in business and government cultures and operational constraints, such as concerns about the confidentiality of shared information, liability, and the limits of volunteerism. The partnership has been facilitated by a business model based on defining shared objectives, identifying mutual needs and vulnerabilities, developing carefully-defined projects, and evaluating proposed project methods through exercise testing. Through collaborative engagement in progressively more complex projects, increasing trust and understanding have enabled the partners to make significant progress in addressing these challenges. CONCLUSION: As a result of this partnership, essential relationships have been established, substantial private resources and capabilities have been engaged in government preparedness programs, and a model for collaborative, emergency mass dispensing of pharmaceuticals has been developed, tested, and slated for expansion. The lessons learned from this collaboration in Georgia should be considered by other government and business leaders seeking to develop similar partnerships.

Bioterrorism↗
PubMed2005

Maps of the Sri Lanka malaria situation preceding the tsunami and key aspects to be considered in the emergency phase and beyond.

BACKGROUND: Following the tsunami, a detailed overview of the area specific transmission levels is essential in assessing the risk of malaria in Sri Lanka. Recent information on vector insecticide resistance, parasite drug resistance, and insights into the national policy for malaria diagnosis and treatment are important in assisting national and international agencies in their control efforts. METHODS: Monthly records over the period January 1995-October 2004 of confirmed malaria cases were used to perform an analysis of malaria distribution at district spatial resolution. Also, a focused review of published reports and routinely collected information was performed. RESULTS: The incidence of malaria was only 1 case per thousand population in the 10 months leading up to the disaster, in the districts with the highest transmission. CONCLUSION: Although relocated people may be more exposed to mosquito bites, and their capacity to handle diseases affected, the environmental changes caused by the tsunami are unlikely to enhance breeding of the principal vector, and, given the present low parasite reservoir, the likelihood of a malaria outbreak is low. However, close monitoring of the situation is necessary, especially as December-February is normally the peak transmission season. Despite some losses, the Sri Lanka public health system is capable of dealing with the possible threat of a malaria outbreak after the tsunami. The influx of foreign medical assistance, drugs, and insecticides may interfere with malaria surveillance, and the long term malaria control strategy of Sri Lanka, if not in accordance with government policy.

Animals↗
PubMed2001

The World Trade Center attack. Similarities to the 1988 earthquake in Armenia: time to teach the public life-supporting first aid?

On 7 December 1988, a severe earthquake hit in Armenia, a former republic of the Soviet Union (USSR); on 11 September 2001, a manmade attack of similar impact hit New York City. These events share similar implications for the role of the uninjured survivor. With basic training, the uninjured survivors could save lives without tools or resuscitation equipment. This article makes the case for teaching life-supporting first aid to the public in the hope that one day, should another such incident occur, they would be able to preserve injured victims until formal rescue occurs.

Aircraft↗
PubMed2006

Hurricanes Katrina and Rita: role of individuals and collaborative networks in mobilizing/coordinating societal and professional resources for major disasters.

The medical support for the coordinated effort for Harris County Texas (Houston) to rescue evacuees from New Orleans following Hurricane Katrina was part of an integrated collaborative network. Both public health and operational health care was structured to custom meet the needs of the evacuees and to create an exit strategy for the clinic and shelter. Integrating local hospital and physician resources into the Joint Incident Command was essential. Outside assistance, including federal and national resources must be coordinated through the local incident command.

Cooperative Behavior↗
PubMed2006

Disaster and emergency communications prior to computers/Internet: a review.

When communications are needed the most desperately and most urgently, the difficulty of effecting the desired communications increases exponentially. Recent natural disasters in different parts of the world have provided eloquent testament to this. The history of disaster or emergency communications can provide us with a foundation for understanding the problems encountered today, and can offer us insight into how we might improve the systems and processes for communications. The first applications of communication technology that allowed messages to be sent more rapidly than the fastest form of transportation were mainly military in origin. This review takes us from the days of optical or visual telegraphy, through the early development of mobile and radio communications, and up to the current sophisticated technologies. We pay particular attention to the use of amateur radio operators in times of emergency, and relate their activities to those of the most effective military communications. The germane assumption made in this discussion is that any emergency or disaster communications would necessarily be involved in response and resolution of medical aspects of those emergencies.

Communication↗
PubMed1993

A mental health relief programme in Armenia after the 1988 earthquake. Implementation and clinical observations.

An international mental health relief programme for children and adults was implemented in Soviet Armenia after the 7 December 1988 Spitak earthquake. This paper presents: (a) the steps considered essential in the selection, preparation and support of mental health workers for the relief work; (b) a method which facilitated the screening and treating of large numbers of students in their classrooms; (c) the rate of post-traumatic stress disorder (74%) and major depressive disorder (22%) of 582 victims clinically evaluated before entering treatment three to six months after the earthquake; (d) clinical observations of significant psychological problems that may be overlooked in brief crisis-orientated psychotherapy; (e) multiple severe post-earthquake adversities (such as the collapse of the social network, the recurrence of after-shocks, the delay of reconstruction and the ongoing political turmoil) which contributed to the psychological problems of the victims and delayed their recovery; (f) the extension of the outreach programme beyond its traditional therapeutic role to an advisory one to other relief organisations.

Adaptation, Psychological↗
PubMed2004

Information technology and emergency medical care during disasters.

Disaster response to mass-casualty incidents represents one of the greatest challenges to a community's emergency response system. Rescuers, field medical personnel, and regional emergency departments and hospitals must often provide care to large numbers of casualties in a setting of limited resources, inadequate communication, misinformation, damaged infrastructure, and great personal risk. Emergency care providers and incident managers attempt to procure and coordinate resources and personnel, often with inaccurate data regarding the true nature of the incident, needs, and ongoing response. In this chaotic environment, new technologies in communications, the Internet, computer miniaturization, and advanced "smart devices" have the potential to vastly improve the emergency medical response to such mass-casualty incident disasters. In particular, next-generation wireless Internet and geopositioning technologies may have the greatest impact on improving communications, information management, and overall disaster response and emergency medical care. These technologies have applications in terms of enhancing mass-casualty field care, provider safety, field incident command, resource management, informatics support, and regional emergency department and hospital care of disaster victims.

California↗
PubMed2006

Equipment, supplies, and pharmaceuticals: how much might it cost to achieve basic surge capacity?

The ability to deliver optimal medical care in the setting of a disaster event, regardless of its cause, will in large part be contingent on an immediately available supply of key medical equipment, supplies, and pharmaceuticals. Although the Department of Health and Human Services Strategic National Stockpile program makes these available through its 12-hour "push packs" and vendor-managed inventory, every local community should be funded to create a local cache for these items. This report explores the funding requirements for this suggested approach. Furthermore, the response to a surge in demand for care will be contingent on keeping available staff close to the hospitals for a sustained period. A proposal for accomplishing this, with associated costs, is discussed as well.

Bioterrorism↗