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• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2, Supplement C: Preparedness and Response in Healthcare Facilities

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  "The goals of a preparedness and response plan in a healthcare facility are: [1] Rapidly identify and isolate all potential SARS [severe acute respiratory syndrome] patients. [2] Implement infection control practices and contract tracing to interrupt SARS-CoV transmission. [3] Ensure rapid communication within healthcare facilities and between healthcare facilities and health departments."

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08
• State of New Hampshire Interim Severe Acute Respiratory Syndrome (SARS) Epidemic Preparedness Plan

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  This report "will assist health care workers and administrators, public officials and the public in appropriate activities toward preparedness and response in the event of a SARS epidemic. If this occurs, the strategies, guidelines and tools contained in this plan will help to rapidly identify SARS cases and their exposed contacts, ensure rapid information exchange and implement and coordinate effective response planning efforts."

  New Hampshire. Department of Health and Human Services

  2004-01-07
• Clark County Health District: 2004 Zoonotic Infectious Disease Surveillance Report

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  "In 2004, the Clark County Health District, Environmental Health Division (EHD), Zoonotic Infectious Disease Program conducted surveillance for several diseases in nature communicable to man, including Baylisascaris procyonis (Raccoon Roundworm), rabies, plague, West Nile Virus, Western Equine Encephalitis, and St. Louis Encephalitis. The following report details the types of animals and insects tested and the results from these surveillance activities."

  Southern Nevada Health District

  Raman, Vivek K.

  2004
• Infectious Disease Risks from Dead Bodies Following Natural Disasters

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  "Victims of natural disasters usually die from trauma and are unlikely to have acute or 'epidemic-causing' infections. This indicates that the risk that dead bodies pose for the public is extremely small. However, persons who are involved in close contact with the dead-such as military personnel, rescue workers, volunteers, and others-may be exposed to chronic infectious hazards, including hepatitis B virus, hepatitis C virus, HIV, enteric pathogens, and Mycobacterium tuberculosis. Suitable precautions for these persons include training, use of body bags and disposable gloves, good hygiene practice, and vaccination for hepatitis B and tuberculosis. Disposal of bodies should respect local custom and practice where possible. When there are large numbers of victims, burial is likely to be the most appropriate method of disposal. There is little evidence of microbiological contamination of groundwater from burial."

  Pan American Health Organization

  Morgan, Oliver

  2004
• Public Health Law and Ethics: Lessons from SARS and Quarantine

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  "The 2003 global outbreak of severe acute respiratory syndrome (SARS) was an abrupt reminder that infectious diseases pose a continuing threat to human health. In 1967, U.S. Surgeon General W.H. Stewart had optimistically declared 'it was time to close the book on infectious diseases.' SARS proved that wrong. Outside Asia, Canada was the country hardest hit by SARS. The outbreak took 44 lives in our country, threatened many others and created numerous challenges for public health officials and the acute health care system. In particular, SARS highlighted serious deficiencies in public health infrastructure and preparedness. As in other countries, officials in Canada were required to weigh the legalities and ethics of various interventions to control the spread of the disease, including quarantine."

  Health Law Review

  Ries, Nola M.

  2004-01-01?
• Fatal Infectious Disease Surveillance in a Medical Examiner Database

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  "Increasing infectious disease deaths, the emergence of new infections, and bioterrorism have made surveillance for infectious diseases a public health concern. Medical examiners and coroners certify approximately 20% of all deaths that occur within the United States and can be a key source of information regarding infectious disease deaths. We hypothesized that a computer-assisted search tool (algorithm) could detect infectious disease deaths from a medical examiner database, thereby reducing the time and resources required to perform such surveillance manually. We developed two algorithms, applied them to a medical examiner database, and verified the cases identified against the opinion of a panel of experts. The algorithms detected deaths with infectious components with sensitivities from 67% to 94%, and predictive value positives ranging from 8% to 49%. Algorithms can be useful for surveillance in medical examiner offices that have limited resources or for conducting surveillance across medical examiner jurisdictions."

  Centers for Disease Control and Prevention (U.S.)

  Wolfe, Mitchell I.; Nolte, Kurt B.; Yoon, Steven S.

  2004-01
• Serial No. 108-210: Beneficial or Critical? The Heightened Need for Telework Opportunities in the Post-9/11 World: Hearing before the Committee on Government Reform, House of Representatives, One Hundred Eighth Congress, Second Session, July 8, 2004

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  From the opening statement of Tom Davis: "Good morning, and I want to welcome everybody to today's oversight hearing on the Status of Telework Programs and Policies in the Federal Government. We are here to determine why many Federal supervisors have been slow to implement telework across all levels of the Government work force. For years now, many of us have recognized that telework offers significant benefits to managers, employees, and society. More recently, and perhaps more importantly, we now realize that telework needs to be an essential component of any continuity of operations plan. Something we once considered advantageous and beneficial has evolved into a cornerstone of emergency preparedness. The innovations of the information age, laptop computers, broadband Internet service, blackberries and so forth, continue to make location less relevant in a working world. Telework capitalizes on these advances, offering a broad range of benefits to employers and employees, and the public." Statements, letters, and materials submitted for the record include those of the following: Pamela J. Gardiner, Scott J. Cameron, J. Christopher Mihm, James A. Kane, Steve DuMont, Eric Richert, Carol Goldberg, Stephen Perry, Kay Coles James, Elijah E. Cummings, Tom Davis, Danny K. Davis, Dennis J. Kucinich, Henry A. Waxman, and Frank Wolf.

  United States. Government Printing Office

  2004
• Quarantine and Police Powers: The Role of Law Enforcement in a Biomedical Crisis

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  This document provides guidance to senior law enforcement officials in instances of biological terrorism.

  Police Executive Research Forum

  Richards, Edward P.; Goodman, Richard; Milligan, Stacy

  2004-01
• S. Hrg. 108-367: SARS: Is Minnesota Prepared? Hearing before the Permanent Subcommittee on Investigations of the Committee on Governmental Affairs, United States Senate, One Hundred Eighth Congress, First Session, Field Hearing in Minneapolis, Minnesota, October 8, 2003

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  This hearing focuses on how Minnesota officials are preparing for a possible outbreak of SARS in the upcoming flu season. In the first outbreak of SARS, there were 8,098 cases in 28 countries. The United States experienced 29 total probable cases of SARS-with the median age being 33-and thankfully no fatalities. Throughout the world, however, 916 people died of SARS-related complications. This hearing discusses what can be done to ensure that the next outbreak of SARS isn't summarized with statistics of who got sick and died-but rather a case study that illustrates how lives can be saved when government and the health care communities- at every level-work together, not just hoping for the best, but being prepared for the worst. "Today's hearing gives us an excellent opportunity to assess our preparedness. We will hear from two of Minnesota's leaders in the area of public health and infectious disease. We will also hear from local officials, and, in particular school, officials who represent the front line of our effort to contain any future outbreak." Statements, letters, and materials submitted for the record include those of the following: Dianne Mandernach, Michael T. Osterholm, Jeff Spartz, Mary Quinn Crow, Ann Hoxie, Debra Herrmann, Rob Benson, and Donna J. Spannaus-Martin.

  United States. Government Printing Office

  2004
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement G: Communication and Education

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  "During the 2003 SARS response, health communications figured prominently among the tools used to contain the outbreak. The response to outbreaks and the threat of outbreaks necessitated extensive communications activities. Experience showed that, although a media/communications plan cannot alleviate the threat of SARS-CoV or solve associated public health problems, good communication can guide the public, the media, and healthcare providers in responding appropriately and complying with exposure-control measures as required. This document describes the communication plans and activities that are suggested to prepare for a possible reappearance of SARS-CoV and activities that would be needed to respond to a SARS outbreak. This plan identifies information necessary for major planning, preparedness, and communication response activities of state and local health departments and provides guidance for coordinating efforts with CDC and other entities."

  Centers for Disease Control and Prevention (U.S.)

  2003-12-29
• Public Law 108-195: Defense Production Act Reauthorization of 2003

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  "An Act to reauthorize the Defense Production Act of 1950, and for other purposes."

  United States. Government Printing Office

  2003-12-19
• Learning from SARS: Preparing for the Next Disease Outbreak -- Workshop Summary

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  This report examines the response to SARS by public health systems within individual countries; the biology of the SARS coronavirus and related coronaviruses in animals; the economic and political fallout of the SARS epidemic; quarantine law and other public health measures that apply to combating infectious diseases; and the role of international organizations and scientific cooperation in halting the spread of SARS. The report provides an illuminating survey of findings from the epidemic, along with an assessment of what might be needed in order to contain any future outbreaks of SARS or other emerging infections.

  National Academies Press (U.S.)

  Knobler, Stacey; Mahmoud, Adel A.F.; Lemon, Stanley M.

  2004
• Early Warning Infectious Disease Surveillance (EWIDS) Guidance

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  This guidance outlines ways to decrease the time needed to detect chemical, biological, radiological agents in tissue, food or environmental samples that cause threats to the public's health; improve the timeliness of information regarding threats to the public's health, and; decrease the time to identify causes, risk factors, and appropriate interventions for those affected by threats to the public's health.

  Centers for Disease Control and Prevention (U.S.)

  2004
• Immunization Safety Review: Influenza Vaccines and Neurological Complications

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  A vaccine exists (the "flu" shot) that can greatly decrease the impact of influenza. Because the strains of virus that are expected to cause serious illness and death are slightly different every year, the vaccine is also slightly different every year and it must be given every year, unlike other vaccines. The influenza vaccine that was used in 1976 for the expected "Swine Flu" epidemic (which never materialized) was associated with cases of a nervous system condition called Guillain-Barr© syndrome (GBS). Ever since that time, public health leaders, doctors and nurses, and the public have wondered whether every year's influenza vaccine can cause GBS or other similar conditions. The Immunization Safety Review committee reviewed the data on influenza vaccine and neurological conditions and concluded that the evidence favored acceptance of a causal relationship between the 1976 Swine Influenza vaccine and GBS in adults. The evidence about GBS for other years' influenza vaccines is not clear one way or the other (that is, the evidence is inadequate to accept or reject a causal relationship). The committee concluded that the evidence favored rejection of a causal relationship between influenza vaccines and exacerbation of multiple sclerosis. For the other neurological conditions studied, the committee concluded the evidence about the effects of influenza vaccine is inadequate to accept or reject a causal relationship. The committee also reviewed theories on how the influenza vaccine could damage the nervous system. The evidence was at most weak that the vaccine could act in humans in ways that could lead to these neurological problems. -- Executive Summary

  National Academies Press (U.S.)

  2004
• Quarantine and Isolation: Lessons Learned from SARS

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  "This report uses the experience with Severe Acute Respiratory Syndrome (SARS) to highlight the broad legal and policy challenges in preparing for an outbreak of infectious disease or similar public health emergency. Based on an analysis of the history of quarantine and isolation, relevant U.S. law, and the roles of various governmental bodies in infectious disease control, as well as lessons learned from detailed case studies of the six jurisdictions at the center of the SARS epidemic (Canada, China, Hong Kong, Singapore, Taiwan, and Vietnam), we identified twelve key issues for public health officials and other policy makers within three broad categories [....]."

  University of Louisville. Institute for Bioethics, Health Policy, and Law

  Rothstein, Mark A.; Alcalde, Gabriela M.; Elster, Nanette R. . . .

  2003-11
• SARS: When a Global Outbreak Hits Home [webcast]

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  This program was originally broadcast October 23, 2003. The archived program includes links to an overview of the program, related resources, an archived discussion, and the webcast of the program. "Early in 2003, a previously unknown, but highly communicable disease was reported in Asia. First identified as atypical pneumonia, it became known as Severe Acute Respiratory Syndrome (SARS). By July 2003, more than thirty countries worldwide had reported cases of SARS. Most of us do not remember the exact moment that we heard about this new, potentially fatal disease, but the public health leaders of Toronto remember the day, time, and where they were. Toronto, in the Ontario province of Canada, suffered the worst outbreak outside of Asia. Because it is a city known for its diversity, it is not surprising that SARS was spread to Toronto by an international traveler. It is precisely this aspect of the outbreak that makes all communities vulnerable and emphasizes the need for increased surveillance, communication, and preparedness. Join us as we discuss the tremendous efforts of Canada's public health professionals, health care workers, and civic leaders to contain the outbreak and protect the health of their citizens now and in the future."

  University of North Carolina at Chapel Hill. School of Public Health

  2003-10-23
• Risk Communication Recommendations for Infectious Disease Outbreaks

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  Scholars in risk communication sometimes distinguish three paradigms. (1) When people are insufficiently alarmed about a serious hazard, the task is to increase their concern and motivate them to take appropriate actions. (2) When people are excessively alarmed about a small hazard, the task is to diminish their concern and deter them from unnecessary and potentially harmful actions. (3)When people are justifiably alarmed about a serious hazard, the task is to harness their concern and guide their actions.

  New York (State). Department of Health

  2003-10-20
• MMWR: Morbidity and Mortality Weekly Report, April 11, 2003

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  The Morbidity and Mortality Weekly Report (MMWR) Series is prepared by the Centers for Disease Control and Prevention (CDC). [It] is the agency's primary vehicle for scientific publication of timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations. This issue of MMWR contains the following: "Severe Acute Respiratory Syndrome (SARS) and Coronavirus Testing - United States, 2003"; "Prevalence of Current Cigarette Smoking Among Adults and Changes in Prevalence of Current and Some Day Smoking - United States, 1996-2001"; "Point-of-Purchase Alcohol Marketing and Promotion by Store Type - United States, 2000-2001"; "Update on Adverse Events Following Civilian Smallpox Vaccination - United States, 2003"; "Notice to Readers: National Infant Immunization Week - April 13-19, 2003"; "Notice to Readers: Epi Info 2002: A Course for Developers of Public Health Information Systems"; "Notice to Readers: Introduction to Public Health Surveillance Course"; and "Notice to Readers: 2003 Conference on Antimicrobial Resistance". Notifiable Diseases and Mortality Tables from this issue can be accessed at the following link [http://www.cdc.gov/mmwr/index2003.htm]"

  Centers for Disease Control and Prevention (U.S.)

  2003-10-03
• Learning from SARS: Renewal of Public Health in Canada

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  The National Advisory Committee on SARS and Public, Health was established in early May 2003 by the, Minister of Health of the Government of Canada, the, Hon. A. Anne McLellan, in the circumstances surrounding, the outbreak of Severe Acute Respiratory Syndrome [SARS]. The Committee's mandate was to provide a third party, assessment of current public health efforts and lessons, learned for ongoing and future infectious disease control." Committee members represented a multitude of disciplines, and perspectives from across Canada. Several were, directly involved in responding to SARS in different, capacities. We reviewed source documents, conducted, interviews, and engaged consultants to undertake surveys,, additional interviews, and analyses to illuminate aspects, of the SARS experience. Advice was also sought from a, constitutional legal expert. Over 30 non-governmental, and voluntary sector stakeholders submitted helpful, briefs and letters."

  Canada. Health Canada

  2003-10-01?
• Learning from SARS: Renewal of Public Health in Canada

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  The National Advisory Committee on SARS and Public Health was established in early May 2003 in the circumstances surrounding the outbreak of Severe Acute Respiratory Syndrome [SARS]. The Committee's mandate was to provide a "third party assessment of current public health efforts and lessons learned for ongoing and future infectious disease control." The committee was asked to build on current public health interventions, and to foster and encourage collaboration among jurisdictions, professionals, and institutions. They were urged to work towards integration of all aspects of the containment of SARS (epidemiology, management, communication, and international coordination). The outbreak of SARS in the Greater Toronto Area was contained during the committee's mandate, as expected. Therefore, the committee extended this integrative approach to their analysis, and recommendations regarding emerging infectious diseases and public health in general. Most of this report deals with two major elements of the committee's mandate: provision of a short-term assessment of lessons learned from current public health interventions to contain SARS, and advice regarding issues for necessary longer-term action regarding infectious disease control and prevention. The committee learned very rapidly that Canada's ability to fight an outbreak such as SARS was tied more closely to the specific strengths of their public health system than to the general capacity of the committee's publicly-funded personal health services system. The committee's analysis and recommendations accordingly set out a plan for a comprehensive renewal of both the public health system in general, and the nation's capacity to detect, prevent, understand, and manage outbreaks of significant infectious diseases.

  Canada. Health Canada

  2003-10
• SARS: Lessons from the First Epidemic of the 21st Century: A Collaborative Analysis with Outside Experts (U)

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  "In June 2003, the CIA's Strategic Assessments Group (SAG) sponsored an unclassified workshop with experts from various health-related disciplines titled 'SARS: Lessons Learned,' held at the National Science Foundation. The group included leading virologists, epidemiologists, public health experts from academia and government, senior officials from WHO and the Centers for Disease Control and Prevention (CDC), and authorities in global public health, health communications, and economics. The meeting's objective was to extract valuable lessons learned to help prepare for future epidemics of new and reemergent infectious diseases. The group reviewed the SARS experience from its medical-scientific, public health, psychosocial and risk communications, economic, and political dimensions. This report conveys the lessons participants found most important for the containment of SARS and for dealing with future epidemics."

  United States. Central Intelligence Agency. Directorate of Intelligence

  2003-09-29
• Questions and Answers Regarding Actions To Take When Ending Shelter-In-Place

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  "Shelter-in-place has found increasing acceptance as an effective protective action option for communities participating in the Chemical Stockpile Emergency Preparedness Program. Studies have confirmed that it can provide optimum protection under certain accident conditions. However, emergency managers and planners, as well as the public, continue to be troubled by the need to end sheltering when the plume has passed in order to avoid sustained exposure to the small amount of agent that has penetrated the shelter. One of the concerns posed by this necessity is uncertainty regarding what hazards will then be faced in the environment outside the shelter and what actions can be taken to avoid those hazards. This report attempts to address those uncertainties. It recognizes that there is an extremely low probability that the environment outside the shelter will be contaminated with chemical agent residue. However, as people comply with an official recommendation to leave their shelters, they probably can't be certain that the environment is free from contamination. Therefore, this report identifies and explains specific and simple actions they can take to avoid the possibility of exposure to chemical agent hazards outside their shelters. It addresses such issues as the actions people should take upon ending shelter-in-place, what clothing they should wear, how they should handle animals, and what they should do about food in their homes and produce in their gardens."

  Oak Ridge National Laboratory

  Shumpert, Barry

  2003-09
• Georgetown University Medical Center Evacuation and Shelter-in-Place Plan

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  This document provides building occupants with guidance and directives to follow in the event of an emergency at Georgetown University Medical Center. It provides plans and instructions for people within the Georgetown Medical Center to either evacuate or shelter-in-place in case of an emergency. LLIS Core Capability: Emergency Management; Healthcare; Private Sector; Private Sector; Private Sector; Private Sector

  Georgetown University. Medical Center

  2003-09
• Hungarian National Plan for the Pandemic Preparedness to Influenza (Interim Working Document)

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  "Influenza is the most important viral infectious disease returning regularly. In case of a medium degree epidemic, 20-40 % of the population can be affected, and considering the epidemiological experiences of the last thirty years, in Hungary the number of complications and lethal cases may be high. The public health authorities in Hungary provide free-of-charge vaccine supply every year for the risk population since many decades. Recently the coverage has reached about 10 % of the total population. The emergence of a pandemic influenza virus, is one of the greatest challenge of the world population. An the planning and organisation of the preventive activities is one of the principal responsibilities of Authorities and Organizations working in public health and medicine. In case of a pandemic epidemiology is facing practically a new virus because of the profound structural changes of the surface of the virus. In this case it is recommended to provide several times higher level of the preventive vaccination, than that usual in interpandemic years in order to prevent the expectable increased number of complicated illensses. The vaccination of the professionals required for the maintenance of the of the everyday functioning of the country will be also necessary. This amount of the killed whole virus vaccine will be more than one million of doses in a country of the size of Hungary."

  Hungary. National Center for Epidemiology

  2003-09
• Hungarian National plan for the pandemic preparedness to influenza

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  National pandemic preparedness plan of Hungary.

  Hungary. National Center for Epidemiology

  2003-09
• SARS (Severe Acute Respiratory Syndrome): Down But Still a Threat

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  "This Intelligence Community Assessment (ICA) was requested by Secretary of Health and Human Services Tommy Thompson and Ambassador Jack Chow, Deputy Assistant Secretary of State for International Health Affairs. It highlights the evolution of Severe Acute Respiratory Syndrome (SARS) and the potential implications of the disease for the United States under several scenarios; this paper does not attempt to provide a scientific assessment of the epidemiology of SARS. Even though SARS has infected and killed far fewer people than other common infectious diseases such as influenza, malaria, tuberculosis, and HIV/AIDS, it has had a disproportionately large economic and political impact because it spread in areas with broad international commercial links and received intense media attention as a mysterious new illness that seemed able to go anywhere and hit anyone."

  National Intelligence Council (U.S.)

  Monaghan, Karen

  2003-08
• Severe Acute Respiratory Syndrome: Established Infectious Disease Control Measures Helped Contain Spread, but a Large-Scale Resurgence May Pose Challenges: Statement of Marjorie E. Kanof, Director, Health Care - Clinical and Military Health Care Issues: Testimony Before the Permanent Subcommittee on Investigations, Committee on Governmental Affairs

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  "Infectious disease experts emphasized that no new infectious disease control measures were introduced to contain SARS in the United States. Instead, strict compliance with and additional vigilance to enforce the use of current measures was sufficient. These measures--case identification and contact tracing, transmission control, and exposure management--are well established infectious disease control measures that proved effective in both health care and community settings. The combinations of measures that were used depended on either the prevalence of the disease in the community or the number of SARS patients served in a health care facility. For SARS, case identification within health care settings included screening individuals for fever, cough, and recent travel to a country with active cases of SARS. Contact tracing, the identification and tracking of individuals who had close contact with someone who was infected or suspected of being infected, was important for the identification and tracking of individuals at risk for SARS. Transmission control measures for SARS included contact precautions, especially hand washing after contact with someone who was ill, and protection against respiratory spread, including spread by large droplets and by smaller airborne particles. The use of isolation rooms with controlled airflow and the use of respiratory masks by health care workers were key elements of this approach. Exposure management practices-- isolation and quarantine--occurred in both health care and home settings. Effective communication among health care professionals and the general public reinforced the need to adhere to infectious disease control measures. While no one knows whether there will be a resurgence of SARS, federal, state, and local health care officials agree that it is necessary to prepare for the possibility. As part of these preparations, CDC, along with national associations representing state and local health officials, and others, is involved in developing both SARS-specific guidelines for using infectious disease control measures and contingency response plans. In addition, these associations have collaborated with CDC to develop a checklist of preparedness activities for state and local health officials. Such preparation efforts also improve the health care system's capacity to respond to other infectious disease outbreaks, including those precipitated by bioterrorism. However, implementing these plans during a large-scale outbreak may prove difficult due to limitations in both hospital and workforce capacity that could result in overcrowding, as well as potential shortages in health care workers and medical equipment--particularly respirators."

  United States. General Accounting Office

  Kanof, Marjorie E.

  2003-07-30
• Contact Tracing for SARS - Then and Now

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  From the Introduction: "The purpose of this paper is to give a descriptive account of the various measures adopted by the Department of Health (DH) to conduct contact tracing during the outbreak of SARS [severe acute respiratory syndrome]."

  Hong Kong. Department of Health

  2003-07
• Norwegian National Influenza Pandemic Preparedness Plan

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  "The objective of this Plan is to ensure that the necessary steps are taken in order to make it possible during a pandemic: To reduce morbidity and mortality; To nurse and treat sick and dying patients at home and in hospital; To uphold essential community services; To give continuous, necessary information to the health services, public authorities, the general public and the mass media."

  Norway. Ministry of Health and Social Affairs

  2003-07
• After Action Report: SARS Complaint, Mid-Continent Airport, Wichita, KS, June 12, 2003

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  "The best way to start an examination of this event is to begin with the sequence of events as much in their entirety as possible, and then analyze what went right, and what can be improved. The situation began in the skies over Oklahoma when a passenger on a commercial flight noticed a person hacking and wheezing. This person, a resident of Wichita, had spent the last three weeks in Hanoi, Vietnam. Another passenger on the flight became convinced the coughing passenger was infected by Severe Acute Respiratory Syndrome (SARS)."

  Sedgwick County Emergency Management

  2003-06-19