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Interim Report of the Defense Science Board Task Force on SARS Quarantine
"The Task Force established by the Defense Science Board (DSB) to assess Department of Defense quarantining guidance for dealing with a Severe Acute Respiratory Syndrome (SARS) epidemic met on three occasions during 2003-2004 to review the status of current and planned Department of Defense (DoD) policies and procedures related to SARS outbreak response. The Task Force received a number of briefings describing SARS and other disease outbreak response and quarantine operations, Centers for Disease Control and Prevention SARS guidelines, lessons learned, DoD global surveillance systems, and military/civilian public health interfaces. We operated at a deliberate pace as both, the course of the outbreak and the maturing institutional responses, were rapidly moving targets."
United States. Defense Science Board
2004-12
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Architecture for Network Centric Operations in Unconventional Crisis: Lessons Learnt from Singapore's SARS Experience
"Singapore and many parts of Asia were hit with Severe Acute Respiratory Syndrome (SARS) in March 2003. The spread of SARS lead to a rapidly deteriorating and chaotic situation. Because SARS was a new infection, there was no prior knowledge that could be referenced to tackle such a complex, unknown and rapidly changing problem. Fortunately, through sound measures coupled with good leadership, quick action and inter-agency cooperation, the situation was quickly brought under control. This thesis uses the SARS incident as a case study to identify a set of network centric warfare methodologies and technologies that can be leveraged to facilitate the understanding and management of complex and rapidly changing situations. The same set of methodologies and technologies can also be selectively reused and extended to handle other situations in asymmetric and unconventional warfare."
Naval Postgraduate School (U.S.)
Chee Bin, Tay; Whye Kee, Mui
2004-12
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Threat of Pandemic Influenza: Are We Ready? Workshop Summary
"[This] workshop summary is organized within chapters as a topic-by-topic description of the presentations and discussions. Its purpose is to present lessons from relevant experience, delineate a range of pivotal issues and their respective problems, and put forth some potential responses as described by the workshop participants. Participants discussed the history of influenza pandemics and the potentially valuable lessons it holds; the 2003-04 H5N1 avian influenza outbreak in Asia and its implications for human health; ongoing pandemic influenza preparedness planning at global, regional, national, states, and local levels; strategies for preventing and controlling avian influenza and its transmission within bird and animal populations; and a broad range of medical, technical, social, economic and political opportunities for pandemic preparedness, as well as the many obstacles that stand in the way of this goal."
National Academies Press (U.S.)
2005
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LLIS Lesson Learned: Crisis Communications: Establishing a Central Media Operations Location
Incident managers should consider establishing a central operations location for the media during large-scale incidents. A central media location can help enhance incident site safety and security while providing the media with visual access to the response effort. LLIS Core Capability: Public Affairs and Information; Emergency Management; 1995: Oklahoma City Murrah Bombing; Law Enforcement
Lessons Learned Information Sharing (LLIS)
2004-11-19?
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Crisis Communications: Keeping Political Leaders Informed of Emergency Response Efforts
The news media often ask elected representatives to comment on emergency response efforts, even if those representatives are not official spokespersons. Incident managers should create a crisis communications plan that identifies and prepares key elected representatives for such media queries.
Lessons Learned Information Sharing (LLIS)
2004-10-29?
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Crisis Communications: Organizing Teleconferences
Following a major emergency, public information officers (PIOs) may consider organizing teleconferences to supplement regular in-person press briefings and interviews. Teleconferences offer the media additional interaction with government experts and officials without requiring the time and logistics necessary to meet each other in person.
Lessons Learned Information Sharing (LLIS)
2004-10-18?
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Emerging Infectious Diseases: Review of State and Federal Disease Surveillance Efforts, Report to the Chairman, Permanent Subcommittee on Investigations, Committee on Governmental Affairs, U.S. Senate
"The threat posed by infectious diseases has grown. New diseases, unknown in the United States just a decade ago, such as West Nile virus and severe acute respiratory syndrome (SARS), have emerged. To detect cases of infectious diseases, especially before they develop into widespread outbreaks, local, state, and federal public health officials as well as international organizations conduct disease surveillance. Disease surveillance is the process of reporting, collecting, analyzing, and exchanging information related to cases of infectious diseases. In this report GAO was asked to examine disease surveillance efforts in the United States. Specifically, GAO described (1) how state and federal public health officials conduct surveillance for infectious diseases and (2) initiatives intended to enhance disease surveillance. GAO reviewed documents, such as policy manuals and reports related to disease surveillance, and interviewed officials from selected federal departments and agencies, including the Departments of Defense (DOD), Agriculture (USDA), and Homeland Security (DHS) as well as the Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC). GAO conducted structured interviews of state public health officials from 11 states."
United States. Government Accountability Office
2004-09-30
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Infectious Disease Preparedness: Federal Challenges in Responding to Influenza Outbreaks, Statement of Janet Heinrich, Director, Health Care--Public Health Issues, Testimony before the Special Committee on Aging, U.S. Senate
Janet Heinrich: "I am pleased to be here today as you discuss issues regarding the annual production and distribution of flu vaccine and preparedness for a worldwide influenza epidemic-known as a pandemic. Each year, influenza viruses cause outbreaks in the United States and elsewhere in the world. Influenza is associated with an average of 36,000 deaths and more than 200,000 hospitalizations each year in the United States. Persons aged 65 and older are involved in more than 9 of every 10 deaths and 1 of every 2 hospitalizations related to influenza. The best way to prevent influenza is to be vaccinated each fall. In the 2000-01 flu season, and again in last year's flu season, this country experienced periods when the demand for flu vaccine exceeded the supply, and there is concern about the availability of vaccines for this and future flu seasons."
United States. Government Accountability Office
2004-09-28
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Canadian Pandemic Influenza Plan
"The Canadian Pandemic Influenza Plan (the Plan) consists of an introduction and a background section, followed by the preparedness, response and recovery sections, which are consistent with the general principals of emergency response. Each section aims to assist and facilitate appropriate planning at all levels of government for the next influenza pandemic. The Centre for Infectious Disease Prevention and Control (CIDPC), Public Health Agency of Canada (PHAC), Health Canada coordinated the development of the Plan in collaboration with the Centre for Emergency Preparedness and Response (CEPR), Health Canada, with direction from the Pandemic Influenza Committee (PIC)."
Public Health Agency of Canada
2004-09-24
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Early Warning Infectious Disease Surveillance (EWIDS) Project: Guidance to Assist the Mexican Border States and the Mexican Secretariat of Health in Preparing Proposals to Enhance and Upgrade Surveillance and Epidemiology Capabilities for Infectious Diseases Along the U.S.-Mexico Border
"Terrorism is an ever-present threat in our times. Bioterrorism is of special concern because its human consequences can be so devastating, its weapons relatively easy to obtain and disseminate, and its effects often not detectable for days or even weeks. The ability of a bioterrorist attack to create massive numbers of casualties (on a scale that overshadows other forms of terrorism) makes bioterrorism today's most dangerous threat. For this reason, the U.S. Government has assigned the highest priority to developing nation-wide domestic capabilities to prepare for and respond to bioterrorism and other outbreaks of infectious diseases. A terrorist-triggered outbreak of a dangerous and highly communicable disease such as smallpox would require a concerted response by the public health emergency response system to prevent catastrophic mortality and morbidity. Because pathogens do not recognize or respect geopolitical boundaries and travelers who cross the border into Mexico from the United States (and vice versa) can spread a contagious disease rapidly, early warning surveillance and prompt sharing of findings of concern among the six Mexican and four U.S. states along the U.S.-Mexico border and beyond is a public health and national security imperative."
United States. Department of Health and Human Services; United States-Mexico Border Health Commission
2004-09-01
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HHS Draft Pandemic Influenza Preparedness and Response Plan: Public Comments to the Plan - Industry
This document includes accumulated comments on the Department of Health and Human Services Draft Pandemic Influenza Preparedness and Response Plan from the following industry representatives: Aventis Pasteur, GlaxoSmithKline, Kaiser Permanente, MedImmune Vaccine, Quidel Corporation, and Roche.
United States. Department of Health and Human Services
2004-08
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HHS Draft Pandemic Influenza Preparedness and Response Plan: Public Comments to the Plan - International
This document includes accumulated comments on the Department of Health and Human Services Draft Pandemic Influenza Preparedness and Response Plan from the Department of Health (United Kingdom) and World Health Organization.
United States. Department of Health and Human Services
2004-08
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HHS Draft Pandemic Influenza Preparedness and Response Plan: Public Comments to the Plan - Associations
This Department of Health and Human Services Draft Pandemic Influenza Preparedness and Response Plan includes accumulated comments from the following associations: American Biological Safety Association, American Hospital Association, American Lung Association & American Thoracic Society, American Society for Microbiology, Association for Occupational Health Professionals, Association for Professionals in Infection Control and Epidemiology, Association of Immunization Managers, Association of Public Health Laboratories, Association of State and Territorial Health Officials, Council of State and Territorial Epidemiologists, Infectious Diseases Society of America, Laboratory Corporation of America, Metropolitan Chicago Healthcare Council, and The Society for Healthcare Epidemiology of America.
United States. Department of Health and Human Services
2004-08
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HHS Draft Pandemic Influenza Preparedness and Response Plan: Public Comments to the Plan - Individuals and DOH
This document includes accumulated comments on the Department of Health and Human Services Draft Pandemic Influenza Preparedness and Response Plan from the following individuals and Department of Health: Andrew Noymer, Andrew Pekosz, Clara Witt, Howard Weinblatt, Idaho Department of Health and Welfare, John Barry, John Hoyle, John Kelley, Jonathan McCullers, Jonathan Temte, Kathleen LeDell, Marc Lipsitch & Christina Mills, Marian McDonald, Marion Kaine, Mark Korbitz, Mary Manley, Merritt Schreiber, Pennsylvania Department of Health, Susan Smith, and the Virginia Department of Health.
United States. Department of Health and Human Services
2004-08
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HHS Draft Pandemic Influenza Preparedness and Response Plan
This is the U.D. Department of Health and Human Services (HHS) Core Document of the August 2004 Draft Pandemic Influenza Preparedness and Response Plan, which was replaced by the Final November 2005 version. The document outlines the purpose and components of the plan, the planning process, goals and coordination of a pandemic response, key pandemic preparedness and response principles, and preparedness activities.
United States. Department of Health and Human Services
2004-08
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SARS Transmission and Commercial Aircraft
This letter to the editor focuses on general information and a study conducted in Berlin with respect to the level of transmission between airline passengers of SARS on commercial aircraft. "The study shows that the roles of public health authorities and the aviation industry should be to "harmonise the protection of public health without the need to avoid unnecessary disruption of trade and travel" in public health emergencies such as global SARS transmission (10). We recommend strengthening the collaboration between national health authorities and the airline industry. Furthermore, the International Air Transport Association should establish procedures to ensure that complete contact information is available for all passengers and that rapid notification can be accomplished in case of potential exposure to infectious diseases."
Centers for Disease Control and Prevention (U.S.)
Breugelmans, J. Gabrielle; Zucs, Phillip; Porten, Klaudia
2004-08
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HHS Pandemic Influenza Response and Preparedness Plan [website]
This purpose of this Pandemic Influenza Preparedness and Response Plan developed by the Department of Health and Human Services (HHS) is to define and recommend preparedness activities that should be undertaken before a pandemic that will enhance the effectiveness of a pandemic response. It is also to describe federal coordination of a pandemic response and collaboration with state and local levels and to describe interventions that should be implemented. The plan includes a core section, which describes coordination and decision making at the national level; provides an overview of key issues for preparedness and response; and outlines action steps to be taken at the national, state, and local levels before and during a pandemic. Annexes 1 and 2 provide information to health departments and private sector organizations to assist them in developing state and local pandemic influenza preparedness and response plans. Annexes 3-13 contain technical information about specific preparedness and response components.
United States. Department of Health and Human Services
2004-08
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Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement E: Managing International Travel-Related Transmission Risk
"The rapid global spread of SARS-CoV in 2003 was facilitated by international travel, as illustrated by the initial dissemination of the SARS outbreak from Hong Kong. Although travelers visiting SARS-affected areas are potentially at risk of contracting SARS-CoV disease, SARS-CoV transmission is generally localized and often limited to specific settings (e.g., hospitals) or households of SARS patients, even in settings with large outbreaks. Consequently, the overall of risk of SARS-CoV disease for outbound travelers who are not exposed to these settings is low. Nevertheless, nearly all U.S. laboratory-confirmed SARS cases were in travelers to SARS-affected areas. Screening and evaluating travelers for SARS-like symptoms, educating them about SARS, and reporting illness should therefore decrease the risk of travel-associated SARS. Because SARS-CoV can sometimes be transmitted on conveyances (e.g., airplanes), it is also important to prevent spread from an ill passenger with a SARS-like illness and to identify and monitor contacts on the conveyance for SARS-like illness. Because of the significant impact of travel on the spread of communicable diseases such as SARS-CoV disease, legal authority exists at local, state, federal, and international levels to control the movement of persons with certain communicable diseases within and between jurisdictions. Measures that might be used to modify the risk of travel-related SARS-CoV disease range from distribution of health alert notices and arrival screening to quarantine of new arrivals and restrictions or prohibitions on nonessential travel. Although the states have authority for movement restrictions within states, federal laws govern movement between states and across international borders."
Centers for Disease Control and Prevention (U.S.)
2004-07-20
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SARS Control and Psychological Effects of Quarantine, Toronto, Canada
"Knowledge and understanding of the experiences of quarantined persons are critical to maximize infectious disease containment and minimize the negative effects on those quarantined, their families, and social networks. The objectives of our study were to assess the level of knowledge about quarantine and infection control measures of persons who were placed in quarantine, to explore ways by which these persons received information, to evaluate the level of adherence to public health recommendations, and to understand the psychological effect on quarantined persons during the recent SARS outbreaks in Toronto, Canada."
Centers for Disease Control and Prevention (U.S.)
Hawryluck, Laura; Gold, Wayne L.; Robinson, Susan
2004-07
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Environmental and Occupational Health Response to SARS, Taiwan, 2003
"Industrial hygiene specialists from the National Institute for Occupational Safety and Health (NIOSH) visited hospitals and medical centers throughout Taiwan. They assisted with designing and evaluating ventilation modifications for infection control, developed guidelines for converting hospital rooms into SARS patient isolation rooms, prepared designs for the rapid conversion of a vacated military facility into a SARS screening and observation facility, assessed environmental aspects of dedicated SARS hospitals, and worked in concert with the Taiwanese to develop hospital ventilation guidelines. We describe the environmental findings and observations from this response, including the rapid reconfiguration of medical facilities during a national health emergency, and discuss environmental challenges should SARS or a SARS-like virus emerge again."
Centers for Disease Control and Prevention (U.S.)
Esswein, Eric J. (Eric John); Kiefer, Max; Wallingford, Ken
2004-07
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Mice Susceptible to SARS Coronavirus
"The outbreak of severe acute respiratory syndrome (SARS) that emerged in China in November 2002 was caused by a novel coronavirus (SARS-CoV) that was detected in lungs, nasopharyngeal aspirates, and feces of infected patients. This outbreak in humans is striking because of the high rate of illness and death associated with it. The SARS-CoV outbreak likely resulted from zoonotic transmission, and natural animal reservoirs of viruses nearly identical to SARS-CoV increase the likelihood of its reemergence in humans." This article covers the technical aspects of experiments done related to the novel coronavirus.
Centers for Disease Control and Prevention (U.S.)
Wentworth, David E.; Gillim-Ross, Laura; Espina, Noel
2004-07
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Collecting Data To Assess SARS Interventions
"With cases of severe acute respiratory syndrome (SARS) occurring across geographic regions, data collection on the effectiveness of intervention strategies should be standardized to facilitate analysis. We propose a minimum dataset to capture data needed to examine the basic reproduction rate, case status and criteria, symptoms, and outcomes of SARS."
Centers for Disease Control and Prevention (U.S.)
Meltzer, Martin; Scott, II, R. Douglas; Gregg, Edward
2004-07
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Emerging Infections: What Have We Learned from SARS?
"Given the current size and mobility of the human population, emerging diseases pose a continuing threat to global health. This threat became reality with the outbreak of severe acute respiratory syndrome (SARS). The emergence of a disease requires two steps: introduction into the human population and perpetuated transmission. Although preventing the introduction of a new disease is ideal, containing a zoonosis is a necessity. The lessons that we have learned from SARS were the topic of a meeting of The Royal Society on January 13, 2004, in London, England." This Conference Summary details the conclusions of that meeting.
Centers for Disease Control and Prevention (U.S.)
Galvani, Alison P.
2004-07
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Psychosocial Impact of SARS
This editorial focuses on the need for research on how SARS affects patients' mental health so that the proper mental health care can be provided at various levels. "Since nearly all resources are devoted to biomedical research and medical treatment, psychosocial problems of SARS patients and their families are largely ignored. Our review of the literature using the ISI Web of Knowledge on January 17, 2004, substantiated this observation. To date, no systematic study examining psychosocial consequences of SARS has been published in scientific journals. A systematic exploration of how SARS negatively affects patients' mental health is needed so that appropriate interventions may be implemented at individual, family, and societal levels."
Centers for Disease Control and Prevention (U.S.)
Tsang, Hector W.H.; Scudds, Rhonda J.; Chan, Ellen Y.L.
2004-07
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Transporting Patient with Suspected SARS
This editorial focuses on the postive effects that the use of portable isolation units (PIU) had in Taiwan during the SARS crisis. Description of the crisis and how the PIUs were used are provided and conclusions of the editorial cite that PIUs "...enabled the safe transport of SARS patients between hospitals by air and road and decreased the risk of cross-infecting transport personnel. The anxiety of transport personnel was decreased, as was the fear felt by the population of the outer islands. In addition, the credibility of the local health authorities was improved among the general population in Taiwan."
Centers for Disease Control and Prevention (U.S.)
Tsai, Shin-Han; Tsang, Chiu-Man; Wu, Hsueh-Ru
2004-07
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Model Parameters and Outbreak Control for SARS
"Severe acute respiratory syndrome (SARS), a viral respiratory disease, has been reported in 32 countries as of July 11, 2003. SARS is believed to have originated in Guangdong Province, China, in November 2002. Researchers at the Erasmus Medical Center in Rotterdam, the Netherlands, identified a coronavirus as the agent responsible for infecting 8,437 persons worldwide, with 813 deaths as of July 11, 2003. According to recent epidemiologic data from Hong Kong, a person exposed to SARS enters an incubation period with a mean length of 6.4 days. Symptomatic persons in that study were hospitalized at a mean rate of 1/4.85 days-1. Those who recovered were discharged a mean of 23.5 days after diagnosis, while the mean period to death was 35.9 days after diagnosis. Because no specific treatment for SARS exists, control of the epidemic relied on rapid diagnosis and isolation of patients, an approach that is reported to be effective. However, most early SARS cases in Toronto occurred in hospitals, with movement of SARS patients between hospitals contributing to the disease?s initial spread. In Taiwan, 94% of SARS cases occurred through transmission in hospital wards, and similar effects occurred in Hong Kong and Singapore. Although the SARS epidemic was eventually controlled, the measures used to achieve that control varied greatly in scope from one place to another. Control of an outbreak relies partly on identifying what disease parameters are likely to lead to a reduction in the reproduction number R0. Here we calculate the dependence of R0 on model parameters."
Centers for Disease Control and Prevention (U.S.)
Chowell, Gerardo; Castillo-Chávez, Carlos; Fenimore, Paul W.
2004-07
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SARS Coronavirus Detection
"Recently, a new coronavirus was identified as the suspected causative agent of an increased number of atypical pneumonia cases reported from Hong Kong, Singapore, Vietnam, and Canada (1-4). Subsequent publications demonstrated that this new coronavirus was detectable in patients with severe acute respiratory syndrome (SARS) (5,6), classified according to the World Health Organization's case definition (7). During the first 6 months of 2003, a total of 8,422 patients were affected. This fact, together with the reappearance of the SARS associated coronavirus (SARS-CoV) in China in late 2003, makes it clear that rapid and reliable diagnostic tools are essential for accurate disease reporting and subsequent disease management."
Centers for Disease Control and Prevention (U.S.)
Nitsche, Andreas; Schweiger, Brunhilde; Ellerbrok, Heinz
2004-07
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Providing Logistical Support to Quarantined Citizens During a Public Health Emergency
"Government and local/regional public health departments should develop plans for providing logistical support to individuals quarantined as a result of a public health emergency. A clear, yet flexible, response plan for delivering food, medicine, and supplies to affected individuals should be developed and widely communicated once a quarantine is announced. Public health officials should coordinate with major volunteer and relief organizations to boost manpower and avoid duplication of effort, and should be receptive to smaller groups willing to offer assistance during a crisis."
Lessons Learned Information Sharing (LLIS)
2004-06-07?
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Epidemiologic Clues to SARS Origin in China
An epidemic of severe acute respiratory syndrome (SARS) began in Foshan municipality, Guangdong Province, China, in November 2002. This document outlines the results of a SARS study on case reports through April 30, 2003, including data from case investigations and a case series analysis of index cases. A total of 1,454 clinically confirmed cases (and 55 deaths) occurred; the epidemic peak was in the first week of February 2003. Healthcare workers accounted for 24% of cases. Clinical signs and symptoms differed between children (65 years). Several observations support the hypothesis of a wild animal origin for SARS. Cases apparently occurred independently in at least five different municipalities; early case-patients were more likely than later patients to report living near a produce market (odds ratio undefined; lower 95% confidence interval 2.39) but not near a farm; and 9 (39%) of 23 early patients, including 6 who lived or worked in Foshan, were food handlers with probable animal contact.
Centers for Disease Control and Prevention (U.S.)
Xu, Rui-Heng; He, Jian-Feng; Evans, Meirion R.
2004-06
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Diagnostic Criteria during SARS Outbreak in Hong Kong
This document details the diagnostic criteria during the SARS outbreak in Hong Kong. The accuracy of diagnostic criteria in the outbreak and the importance of epidemiologic criteria are discussed. The document concludes that further studies are needed to evaluate the diagnostic accuracy of these criteria in a nonoutbreak situation when the case prevalence is low. A novel coronavirus caused more than 8,000 probable cases of severe acute respiratory syndrome (SARS) worldwide during the 2003 outbreak. Before the etiologic agent was identified, the diagnosis of SARS was made according to a set of clinical-epidemiologic criteria as suggested by the Centers for Disease Control and Prevention (CDC).
Centers for Disease Control and Prevention (U.S.)
Chan, Louis Y.; Lee, Nelson; Chan, Paul K.S.
2004-06
