EEppiiddeemmiicc AAlleerrtt aanndd RReessppoonnssee iinn EEmmeerrggeenncciieess

Dr. Mike Ryan, Director Dep artm ent of E p id em ic and P and em ic A lert and Res p ons e C om m u nicab le Dis eas e C lu s ter 2 7 th N ov em b er 2 0 0 6 Epidemic and Pandemic Alert and Response OOVVEERRVVIIEEWW

òò BB aacckkgg rroouu nndd aanndd PP rriinncciipp lleess ooff EE pp iidd eemm iicc AA lleerrtt aanndd RReess pp oonnss ee

òò PP rreepp aarreedd nneess ss PP llaannnniinngg

òò EE pp iidd eemm iicc DDeetteeccttiioonn,, IInnvv eess ttiigg aattiioonn aanndd RReess pp oonnss ee

òò IInntteerrnnaattiioonnaall AA ss pp eeccttss

Epidemic and Pandemic Alert and Response EEppiiddeemmiiccss aanndd PPaannddeemmiiccss hhaavvee sshhaappeedd oouurr hhiissttoorryy……

1stMillenium

SpreadM ofi d19d18le In Aflugenezsa Pandemic in USA

Epidemic and Pandemic Alert and Response TThheeyy ccoonnttiinnuuee ttoo tthhrreeaatteenn uuss.... …and place sudden intense demands on national and international health systems ….on some occasions have brought systems to the point of collapse

W HO has verified more than 1240 events between January 2001 and October 2006

Epidemic and Pandemic Alert and Response EEppiiddeemmiicc CCoonnttrrooll RReeqquuiirreess……

1 . S trong national p u b lic h ealth s ys tem s and cap acity 2 . S p ecific p rep ared nes s for key p riority d is eas e th reats (e.g . S O P s , d iag nos tics , d ru g s , v accines , p rotectiv e eq u ip m ent, containm ent m eas u res ) 3 . A n effectiv e international s ys tem and p artners h ip for coord inated alert and res p ons e

Epidemic and Pandemic Alert and Response WW hhaatt iiss aann oouuttbbrreeaakk//eeppiiddeemmiicc??

ò A n u nu s u al occu rrence of m ore cas es of d is eas e th an ex p ected in a g iv en area am ong a s p ecific g rou p of p eop le ov er a p articu lar p eriod of tim e ò A p u b lic h ealth em erg ency

ò A n econom ic em erg ency

ò A p olitical em erg ency

ò S u rv eillance failu re

ò C ontrol failu re

ò A n ev ent req u iring rap id and coord inated action (…a s tres s tes t for th e p u b lic h ealth s ys tem !!)

ò A n op p ortu nity !

Epidemic and Pandemic Alert and Response SSppeecciiffiicc ddeemmaannddss ww hheenn iinnvveessttiiggaattiinngg oouuttbbrreeaakkss

• Unexpected event • Need to act quickly • Need for rapid control • Many players

Systematic approach

Epidemic and Pandemic Alert and Response EEppiiddeemmiicc FFiieelldd OOppeerraattiioonnss -- FFuunnccttiioonnss

Traditional Medical Burial Screening Clinical Teams healers Anthropology IN / OUT trials

Posters Psycho Social Case Barrier Radio Social Nursing Mobilization and support Management Community Discussion Health Education W ater Sanitation

Media Coordination Environment

Mobile Contact Teams Surveillance Tracing Logistics Roads Case and Security Epidemiology Finding Police Laboratory Sample Data Collection Transports Reporting Salaries Management Vehicles Results Testing

Epidemic and Pandemic Alert and Response OOuuttbbrreeaakk AAlleerrtt aanndd RReessppoonnssee First Late Delayed Case Detection Response

90 80 70 60 CASES 50 Opportunity 40 for control 30 20 10 0

1 4 7 0 3 6 9 2 5 8 1 4 7 0 1 1 1 1 2 2 2 3 3 3 4 DAY Epidemic and Pandemic Alert and Response OOuuttbbrreeaakk AAlleerrtt aanndd RReessppoonnssee

Early Rapid Detection Response

90 80 70 Control 60 CASES 50 Opportunity 40 30 20 10 0

1 4 7 0 3 6 9 2 5 8 1 4 7 0 1 1 1 1 2 2 2 3 3 3 4 DAY Epidemic and Pandemic Alert and Response OObbjjeeccttiivveess ooff EEppiiddeemmiicc PPrreeppaarreeddnneessss,, AAlleerrtt aanndd RReessppoonnssee

1.Prevention/Anticipation/prediction • so that epidemics be prevented (e.g. measles) 2. Early detection • to know when there is a problem (e.g. EW ARS) 3.Rapid Response • SOPs/ staff/supplies (in place before epidemic) 4. Effective Response • appropriate control methods • good co-ordination • adequate resources and logistics • after-action evaluation

Epidemic and Pandemic Alert and Response EEppiiddeemmiicc AAlleerrtt aanndd RReessppoonnssee

ò AA nnttiicciipp aattiioonn

ò PP rreevv eennttiioonn

ò PP rreepp aarreedd nneess ss

ò DDeetteeccttiioonn

ò RRiiss kk AA ss ss eess ss mm eenntt

ò RRiiss kk CC oomm mm uu nniiccaattiioonn

ò RReess pp oonnss ee

ò EE vv aalluu aattiioonn

Epidemic and Pandemic Alert and Response PPrreevveennttiioonn PPrreeppaarreeddnneessss PPllaannnniinngg

Epidemic and Pandemic Alert and Response AAnnttiicciippaattiioonn aanndd PPrreevveennttiioonn

ò KK nnooww nn RRiiss kkss œ E p id em iolog ical P rofile (h is torical p rofile of ep id em ic th reats ) œ S p ecific ep id em ic th reats related to th e ev ent (flood /T s u nam i v s d is p lacem ent)

ò PP rreevv eennttiioonn œ E d u cation/s ocial m ob ilis ation œ Im m u nis ation œ W ater/S anitation/H yg iene œ L iv ing cond itions /cam p d es ig n

Epidemic and Pandemic Alert and Response PPrreeppaarreeddnneessss

òò KK nnooww tthh ee rriiss kkss

òò SS eett PP rriioorriittiieess

òò PP llaann

òò CC oo--oorrdd iinnaattee

òò IImm pp lleemm eenntt

Epidemic and Pandemic Alert and Response PPrriioorriittyy SSeettttiinngg

W hat are the major epidemic prone diseases ?

W hat is the risk of an epidemic ? • time since last outbreak, frequency of outbreaks

W hat would be the likely impact of an epidemic ? • Potential number of cases/deaths, likelihood of spread

Control measures ? • Are effective and affordable measures available ?

Resources ? • Do you have adequate resources ? Epidemic and Pandemic Alert and Response Priority setting - II

Epidemic Risk Impact Control Resources prone disease measures

Cholera High High X Meningitis Low High

Measles Low Low

JE High Low X Low High Malaria X Low Low Viral HF Epidemic and Pandemic Alert and Response EEppiiddeemmiicc PPrreeppaarreeddnneessss PPllaannnniinngg

ò List the priority diseases

ò Define the surveillance, preparedness and response measures to be implemented

ò Identify responsibilities (who does what)

ò Identify co-ordination mechanisms (leadership)

ò Specify resources available for preparedness and response (budget)

Epidemic and Pandemic Alert and Response EEppiiddeemmiicc PPrreeppaarreeddnneessss PPllaannnniinngg

ò W hat should be done ?

ò W ho should do it ?

ò W hat resources or supplies will be required ?

Epidemic and Pandemic Alert and Response CCoonnttrrooll mmeeaassuurreess aarree bbaasseedd oonn kknnoowwlleeddggee ooff::

òò DDiisseeaassee ttrraannssmmiissssiioonn œ reservoir, sources, routes òò IInnffeeccttiioouuss pprroocceessss œ exposure, infection, disease òò PPaatthhooggeenneessiiss ooff ddiisseeaassee ssttaattee œ target organs, virulence, immune response òò NNaattuurraall hhiissttoorryy òò EEffffeeccttiivveenneessss ooff ccoonnttrrooll mmeeaassuurreess

Epidemic and Pandemic Alert and Response MM aajjoorr ttrraannssmmiissssiioonn rroouutteess

Insects Vector borne Droplet Animals

Sexual Food Direct Environmental Blood W ater

Skin to skin Drop. nuclei Other Airborne Dust

Epidemic and Pandemic Alert and Response DDooeess aa ppootteennttiiaall ccoonnttrrooll mmeeaassuurree rreedduuccee

òò TTrraannssmmiissssiioonn

òò EExxppoossuurree

òò IInnffeeccttiioonn òò DDiisseeaassee ?

òò DDeeaatthh

òò DDiissaabbiilliittyy

Epidemic and Pandemic Alert and Response PPrriinncciipplleess ooff ccoonnttrrooll

ò P rev ent ex p os u re ò P rotect s u s cep tib les from infection ò P rev ent p rog res s ion from infection to d is eas e ò T reat cas es œ P re v e n t d e a th a n d d is a b ility œ P re v e n t fu rth e r tra n s m is s io n ò Interru p t trans m is s ion œ E n v iro n m e n ta l œ S o c ia l/b e h a v io u ra l œ L e g a l Epidemic and Pandemic Alert and Response Pathways of Disease Transmission

HOST Exposure PATHOGEN

D V E i e n r c v t Incubation e i c o r Period t r

PATHOGEN Infection

Disease

Epidemic and PDaenatdhemic AleRret caonvedr yResponse Exposure HOST

D V E Susceptibility i e n - previous exposure r c v - immunity e t i - compromise c o r - prophylaxis t r

Infection

Disease

Death Recovery Epidemic and Pandemic Alert and Response Exposure HOST

D V E i e n r c v e t i c o r t r

General health Nutrition Infection Immunity Virulence Immune response Prophylaxis Disease

Death Recovery Epidemic and Pandemic Alert and Response Exposure HOST

D V E i e n r c v e t i c o r t r

Infection

Disease Treatment Death Recovery Epidemic and Pandemic Alert and Response Control

œ W here does it fit in?

Epidemic and Pandemic Alert and Response Points for control m easures Exposure 7

D V E i e n r c v 1 e 6t i c o r t r

Infection 4

2 5 Disease 3

Death Recovery Epidemic and Pandemic AleDrti saanbdili tRyesponse Points for control m easures Exposure

D V E i e n r c v Vaccination 1 e t i c o r t r

Infection

Disease

Death Recovery Epidemic and Pandemic AleDrti saanbdili tRyesponse Points for control m easures Exposure

D V E i e n r c v e t i c o r t r

Infection

Prophylaxis 2

Disease

Death Recovery Epidemic and Pandemic AleDrti saanbdili tRyesponse Points for control m easures Exposure

D V E i e n r c v e t i c o r t r

Infection

Treatment Disease Rehabilitation 3 Death Recovery Epidemic and Pandemic AleDrti saanbdili tRyesponse Points for control m easures Exposure

D V E i e n r c v e t i c o r t r

Isolation Infection 4 Treatment

5 Disease

Death Recovery Epidemic and Pandemic AleDrti saanbdili tRyesponse Points for control m easures Exposure

D V E 6 i e n r c v t Infection control e i o Vector mgt c r t r W ater treatment

Infection

Disease

Death Recovery Epidemic and Pandemic AleDrti saanbdili tRyesponse Points for control Repellents m easures Exposure 7 Bednets

D V E i e n r c v e t i c o r t r

Infection Isolation

Disease

Death Recovery Epidemic and Pandemic AleDrti saanbdili tRyesponse Points for control Repellents m easures 7 Bednets Exposure

D V E i e n Vaccination r c v 1 6 e t i Infection control c o r Vector mgt t r W ater treatment

Infection 4 Isolation treatment Prophylaxis 2

Disease 5 Treatment 3 Death Recovery Epidemic and Pandemic AleDrti saanbdili tRyesponse EEppiiddeemmiicc DDeetteeccttiioonn,, IInnvveessttiiggaattiioonn aanndd RReessppoonnssee

Epidemic and Pandemic Alert and Response Routine surveillance Clinical / Laboratory Detection General public Media

Epidemic and Pandemic Alert and Response Routine surveillance Clinical / Laboratory Detection General public Media

Is this an outbreak?

Epidemic and Pandemic Alert and Response Routine surveillance Clinical / Laboratory Detection General public Media

Is this an outbreak?

Diagnosis verified? Link between cases? Higher than expected?

Epidemic and Pandemic Alert and Response Outbreak confirmed V

Immediate control Further measures? investigation?

- Prophylaxis - Unknown aetiology - Exclusion / isolation - Cases serious - Public warning - Cases still occurring - Hygienic measures - Public pressure - Others - Training opportunity - Scientific interest

Epidemic and Pandemic Alert and Response Outbreak confirmed, further investigations warranted

Form Outbreak Epidemiologist Microbiologist Control Team? Clinician Environmentalist Government Press officer Team coordinates Others field investigation

Epidemic and Pandemic Alert and Response Descriptive epidemiology

- W ho are the cases? - W here do they live? - W hen did they become ill?

Epidemic and Pandemic Alert and Response Clearly identifiable groups Identify & count Hospitals, GPs Laboratories cases Schools W orkplace, etc

Epidemic and Pandemic Alert and Response Identify & count cases

Obtain information

Identifying information Demographic information Clinical details Risk factors

Epidemic and Pandemic Alert and Response Identify & count cases

Obtain information

Orient cases in Analysis of descriptive - time data - place - person Epidemic and Pandemic Alert and Response Cases

Person Time

1200 25 1000 Place 20 800 15 600 400 10 200 5

0 0 0-4 '5-14 '15- '45- '64+ 1 2 3 4 5 6 7 8 9 10 44 64 Age G roup

Evaluate information

Pathogen? Source? Transmission? Epidemic and Pandemic Alert and Response DDeevveelloopp hhyyppootthheesseess

- W hat is the disease? - W ho is at risk of becoming ill? - W hat is the source and the vehicle? - W hat is the mode of transmission?

Epidemic and Pandemic Alert and Response Implement control measures

May (must) occur at any time during the outbreak!!

Control the source of pathogen Interrupt transmission Modify host response

Epidemic and Pandemic Alert and Response AApppprrooaacchh ttoo ccoonnttrrooll

ò W hat is feasible?

ò W hat is available?

ò W hat is effective?

ò W hat is affordable?

Epidemic and Pandemic Alert and Response CCoonnttrrooll oobbjjeeccttiivveess sshhoouulldd bbee

ò Realistic

ò Quantitative (time, place, person)

ò Periodically evaluated

ò Flexible

Epidemic and Pandemic Alert and Response PREPAREDNESS OUTBREAK CONTROL

Investigate Priorities Planning Detect & Analyse Co-ordination Confirm Resources Supplies Respond Training Predict Treat & Prevent Surveillance Control Response Evaluate

Epidemic and Pandemic Alert and Response IInntteerrnnaattiioonnaall AAssppeeccttss

-- EE pp iidd eemm iicc aanndd PP aanndd eemm iicc AA lleerrtt aanndd RReess pp oonnss ee ((EE PP RR)) -- IInntteerrnnaattiioonnaall HH eeaalltthh RReegg uu llaattiioonnss ((IIHH RR)) -- GG lloobb aall OO uu ttbb rreeaakk AA lleerrtt aanndd RReess pp oonnss ee NN eettww oorrkk ((GG OO AA RRNN ))

Epidemic and Pandemic Alert and Response CCHHAALLLLEENNGGEE

ß Ensuring that Member States and the international community can rapidly share information, mobilise resources and implement rational control measures in the face of a major public health emergency

ß Getting immediate access to the appropriate expertise and utilising and focusing that knowledge to support countries facing disease threats

ß Turning knowledge gained into effective interventions in time to make a difference !

No single institution has all the capacity!

W HO brings partners together to focus and coordinate global resources Epidemic and Pandemic Alert and Response EEppiiddeemmiicc && PPaannddeemmiicc AAlleerrtt && RReessppoonnssee ((EEPPRR))

Director‘s Office IHR coordination Programme

Programme Lyon Office Management for National Epidemic Communications Preparedness and Response BioRiskReduction, Bioterrorism IHR Dangerous Alert & Response secretariat Pathogens Operations

Epidemic Global Influenza Readiness Programm & Interventions National Training Systems Support Strengthening Programmes

Epidemic and Pandemic Alert and Response EEPPRR --VViissiioonn

"…An integrated global epidemic alert and response system for international public health emergencies based on strong national public health capacity and an effective international system for coordination…"

Epidemic and Pandemic Alert and Response EEPPRR EExxppllooiittss tthhee SSttrreennggtthhss ooff WW HHOO

ò International Mand ate œ C los e collab oration w ith W H O m em b er s tates u nd er th e fram ew ork of th e rev is ed International H ealth Reg u lations

ò Decentralis ed S tru ctu re & C ap acity œ A b ility to act as a reg ional and g lob al co-ord inating force w ith 6 Reg ional O ffice h u b s and 1 4 2 cou ntry offices

ò E x p erience œ B u ild ing national p u b lic h ealth cap acity and co-ord inating u rg ent international action and com m u nication (e.g . S A RS )

ò P artners h ip s œ N etw orking w ith and m ob iliz ation of th e b es t tech nical ins titu tions inclu d ing th e G lob al Influ enz a s u rv eillance N etw ork , th e G lob al O u tb reak A lert and Res p ons e N etw ork (G O A RN )

Epidemic and Pandemic Alert and Response WW HHOO EEPPRR –– WW hhaatt ddoo ww ee ddoo ??

ò S treng th en C ore C ap acities in p rep ared nes s , early w arning and res p ons e at national lev el

ò T h reat-s p ecific p rep ared nes s and conting ency p lanning (Influ enz a, m ening itis , yellow fev er, s m allp ox , p lag u e, h aem orrh ag ic fev ers , accid ental and d elib erate ep id em ics ) œ Diag nos tics /s u rv eillance tools œ Dru g and v accine d ev elop m ent inc. International S tockp iling œ T raining in ep id em iolog y/lab /clinical m g t and s ocial m ob iliz ation

ò S ens itiv e g lob al d is eas e intellig ence g ath ering and v erification

ò C ollab orativ e ris k as s es s m ent, effectiv e inform ation m anag em ent and rap id ris k com m u nication and tracking of d is eas e s p read

ò Rap id p rov is ion of tech nical s u p p ort and d ep loym ent of field res p ons e team s from G O A RN as w ell as international s tockp iles .

ò S cientific co-ord ination for d is eas e u nd ers tand ing and ch aracteris ation as w ell as d ev elop m ent and as s es s m ent of control m eas u res and interv entions

ò Real-tim e g lob al coord ination u s ing th e S trateg ic H ealth O p erations C entre

Epidemic and Pandemic Alert and Response IInntteerrnnaattiioonnaall HHeeaalltthh RReegguullaattiioonnss ((22000055))

ò T h e International H ealth Reg u lations (IH R) as rev is ed in 2 0 0 5 rep res ent a m ajor s tep forw ard in international coop eration and collectiv e action in th e fig h t ag ains t th e s p read of ep id em ics and p and em ics .

ò T h ey em b od y a u niq u e s trateg ic ap p roach for collectiv e d efence ag ains t th es e th reats .

ò C om p liance w ith th es e m od erniz ed Reg u lations w ill h elp ens u re th at th e w orld is not taken b y s u rp ris e w h en ou tb reaks occu r and th at d is ru p tions to trad e, com m erce, and b u s ines s continu ity are m inim iz ed .

ò T h ey w ill increas e th e s p eed of ou tb reak d etection, allow ing m ore rap id ap p lication of life-s av ing interv entions and m ore rap id alerts to th e international com m u nity ab ou t th e ev olv ing s itu ation.

Epidemic and Pandemic Alert and Response ……ttoowwaarrdd aa GGlloobbaall IIHHRR FFrraammeewwoorrkk,, 11999955 --22000055

Outbreak Creation of GOARN Verification List EMC 1995 2000 1997 International GPHIN Coordination W HA 1995 W HA 2001 1997-98 Global Health Group 1996 Security Anthrax Nipah Meningitis Ebola Sm allpox Yellow fever Plague IHR Regional SARS Consultations 2004-05 Marburg Avian Influenza Pandem ic ? Polio/ (Angola) threat H5N1 Measles

IHR Inter- W HA 2005 W HA 2006 governmental W HA 2005 Immediate voluntary W orking Group AAddoopptitoionn o of f IHR(2005) implementation 2004-05 IHR(2005)

Epidemic and Pandemic Alert and Response IIHHRR:: FFiivvee kkeeyy cchhaannggeess

± B road er s cop e….P u b lic H ealth E m erg ency of International C oncern (P H E IC )

± O p erational….. Real tim e inform ation s h aring and co-ord ination

± C ore C ap acities ….N ew ob lig ation: N ational s u rv eillance/res p ons e cap acities

± F lex ib le Recom m end ed Meas u res ….. ad ap ted to ris k as s es s m ent

± E x ternal ad v ice/T rans p arency….. E m erg ency C om m ittee, Rev iew C om m ittee

Epidemic and Pandemic Alert and Response Epidemic Epidemic Alert and Intelligence Response operations Epidemiological Verification and Risk Assessment

Public Health Response

Follow-up

Epidemic and Pandemic Alert and Response SSttaannddaarrdd ““OOppeerraattiioonnss”” uunnddeerr IIHHRR

ò Id entify œ ev ents th at cou ld th reaten p u b lic h ealth acros s international b ord ers ò A s s es s œ ris k th at th e ev ent w ill h av e international rep ercu s s ions ò A s s is t - res p ons e œ affected cou ntries to contain th reat (and ad d res s h u m anitarian im p act) ò Inform /A lert œ oth er cou ntries (and G O A RN ) for p rep ared nes s and res p ons e ò Initiate P H E IC p roces s œ for ev ents th at m ay req u ire tem p orary recom m end ations of international control m eas u res

Epidemic and Pandemic Alert and Response Epidemic and Pandemic Alert and Response International Outbreak Response

2 0 0 0 /2 0 0 6

 More th an 6 0 cou ntries

 More th an 6 0 G O A RN p artners s ent s taff to th e field

 More th an 4 5 0 ex p erts

 More th an 7 0 ou tb reak res p ons e op erations , inclu d ing A v ian F lu , S A RS ,E b ola, Marb u rg , P lag u e…

Epidemic and Pandemic Alert and Response IIHHRR((22000055)) –– AAlleerrtt aanndd RReessppoonnssee OOppeerraattiioonnss

Others sources Informal/Unofficial Information IHR Reports Disseminate Public IHR National Focal Health Information Point(s) Verification

Public Health Initial Event Risk Emergency of screen Assessment International Concern W HO (PHEIC) Assessment

Assistance / Response

Epidemic and Pandemic Alert and Response RReeggiioonnaalliizzaattiioonn ooff eeppiiddeemmiicc aalleerrtt aanndd rreessppoonnssee ssyysstteemm

Epidemic and Pandemic Alert and Response GGlloobbaall EEvveenntt MM aannaaggeemmeenntt SSyysstteemm

S u p p ort and facilitate th e W H O Organization-wideev ent m anag em ent p roces s -

Surveillance and Response AAnnaallyyssiiss Risk Assessm ent

Inform and d ocu m ent key d ecis ions . A ccom m od ate and p rom ote IH R(2 0 0 5 ) s p ecific activ ities and rep orting .

Epidemic and Pandemic Alert and Response GGOOAARRNN –– EEssttaabblliisshheedd AApprriill,, 22000000

ò N o s ing le ins titu tion h as all th e cap acity! œ a g lo b a l te c h n ic a l n e tw o rk o f (fro m 7 0 to 1 4 0 ) p a rtn e r in s titu tio n s a n d n e tw o rk s ò F ocu s and coord inate g lob al res ou rces - local > reg ional > g lob al œ C o o rd in a te d /s u p p o rte d b y W H O to p ro v id e ra p id in te rn a tio n a l te a m s u p p o rt to c o u n trie s fo r o u tb re a k re s p o n s e

Epidemic and Pandemic Alert and Response GGOOAARRNN’’ss PPrriimmaarryy AAiimmss

¢ Assist countries with disease control efforts by ensuring rapid appropriate technical support to affected populations ¢ Investigate and characterize events and assess risks of rapidly emerging epidemic disease threats ¢ Support national outbreak preparedness by ensuring that responses contribute to sustained containment of epidemic threats

Epidemic and Pandemic Alert and Response WW hhaatt ddooeess GGOOAARRNN pprroovviiddee??

ò A cces s to res ou rces , inform ation ex ch ang e and s h aring of b es t p ractice, tech nolog y trans fer.

ò Red u ce v u lnerab ility and s treng th en res ilience, p rov id e red u nd ancy.

ò A llev iate cos ts , b y im p rov ing th e u s e/m ob iliz ation of res ou rces , and p rov id ing s u rg e cap acity.

ò S treng th en trans p arency and cred ib ility, enh ance d ialog u e and b u ild tru s t.

ò T h e O p erational arm of th e IH R

Epidemic and Pandemic Alert and Response GGOOAARRNN aatt UUNN SSuummmmiitt

PPaarraa 5577 ((ee))…… EEnnssuurree tthhee ffuullll iimmpplleemmeennttaattiioonn ooff oouurr oobblliiggaattiioonnss uunnddeerr tthhee IInntteerrnnaattiioonnaall HHeeaalltthh RReegguullaattiioonnss aaddoopptteedd bbyy tthhee 5588tthh WWoorrlldd HHeeaalltthh AAsssseemmbbllyy iinn MMaayy 22000055,, iinncclluuddiinngg tthhee nneeeedd ttoo ssuuppppoorrtt tthhee GGlloobbaall OOuuttbbrreeaakk AAlleerrtt aanndd RReessppoonnssee NNeettwwoorrkkooff tthhee WWoorrlldd HHeeaalltthh OOrrggaanniizzaattiioonn

Epidemic and Pandemic Alert and Response GGOOAARRNN OOppeerraattiioonnaall CCoommmmuunniiccaattiioonnss

ò N etw ork A lert ò Req u es t for A s s is tance ò S itRep s , O p erational U p d ates ò T ech nical coord ination and com m u nications w ith th e field ò W eekly O V L , W H O W eb ò T ech nical g u id elines , cou ntry p rofiles

Epidemic and Pandemic Alert and Response OOppeerraattiioonnss -- FFiieelldd RReessppoonnssee

ò T rig g ered b y a req u es t for as s is tance from a W H O Mem b er S tate for ou tb reak control

ò Rap id alert, and coord ination of an international res p ons e team œ ins titu tion-b as ed , T O R, cod e of cond u ct œ local > reg ional > g lob al œ trans p arent – w h ole netw ork inv olv ed

ò S tand ard iz ed d ep loym ent, s afety and s ecu rity, log is tics

ò O v ers ig h t/E v alu ation b y S teering C om m ittee

Epidemic and Pandemic Alert and Response SSppeecciiaalliisseedd FFiieelldd LLooggiissttiiccss SSuuppppoorrtt

ò O p erational s u p p ort-in-the-field

ò L og is tics coord ination w ith g ov ernm ental and non-g ov ernm ental actors

ò Manag ing s ecu rity, s tockp iles , eq u ip m ent, s u p p lies , p eop le, m oney, m ob ility and trans p ortation

ò Maintaining IT and field com m u nications s ys tem s and eq u ip m ent

ò Manag ing and p rov id ing s p ecializ ed training in P P E , com m u nications , s afe b u rials .

ò E v alu ating and rev iew ing field ex p eriences .

Epidemic and Pandemic Alert and Response OOuuttbbrreeaakk RReessppoonnssee LLooggiissttiiccss,, DDuubbaaii

ò G rou nd trans p ortation and air liais on; 6 v eh icles

ò Rad io com m u nication, IT and s atellite s ys tem p rov is ion

ò S tockp iling and d ep loym ent of es s ential ou tb reak res p ons e eq u ip m ent and s u p p lies

ò F ield s ecu rity and d om es tic eq u ip m ent p rov is ion: 4 trailers

Epidemic and Pandemic Alert and Response OOuuttbbrreeaakk RReessppoonnssee TTrraaiinniinngg

ò Res id ential cou rs es in international ou tb reak res p ons e ò P articip ativ e ap p roach v ia role p lays , cas e s tu d ies and p ractical ex ercis es . œ C oord ination and lead ers h ip . œ W H O role, ob jectiv es and p roced u res . œ P ers onal and op erational s ecu rity and log is tics . œ H ealth on m is s ion. œ F ield ep id em iolog y. œ C as e m anag em ent and infection control. œ S ocial m ob iliz ation and anth rop olog y. œ W orking in s u p p ort of national p artners . œ Ris k com m u nication. Epidemic and Pandemic Alert and Response FFiieelldd IInnffoorrmmaattiioonn MM aannaaggeemmeenntt SSyysstteemm ((FFIIMM SS))

ò F inaliz ation of F ield Inform ation Manag em ent S ys tem (F IMS ) for inv es tig ation of clu s ters of cas es w ith integ rated m anag em ent of cas e, contact, lab oratory and clinical d ata.

Epidemic and Pandemic Alert and Response FFIIMM SS -- WW hhaatt iitt ddooeess??

• C as e and contact d ata reg is tration • C reation of ad h oc q u es tionnaires and tem p lates • A u d it log on ch ang es ov er p eriod s of tim e • E nh anced contact m onitoring • F lex ib le s earch • Du p licate tracking and m erg ing d u p licate record s • Ins tallation p ackag e • Mu ltip le lang u ag e fu nctionality • Integ ration w ith v is u alis ation tools • Integ ration w ith W H O H ealth Map p er • B ar cod es

Epidemic and Pandemic Alert and Response THANK YOU

Epidemic and Pandemic Alert and Response Epidemic and Pandemic Alert and Response