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SARS and International Law
"The outbreak of a new infectious disease-Severe Acute Respiratory Syndrome (SARS)-in Asia and its spread to many countries in the Asian region and beyond raise many public health and policy questions and challenges for governments, international organizations, and non-governmental organizations. The SARS outbreak also implicates international law, and this Insight briefly discusses three areas of international law affected by SARS and the efforts to contain the spread of the disease."
American Society of International Law
Fidler, David P.
2003-04
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MMWR: Morbidity and Mortality Weekly Report, October 17, 2003
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: "Infants Tested for Hearing Loss - United States, 1999-2001"; "Prevalence of IgG Antibody to SARS-Associated Coronavirus in Animal Traders - Guangdong Province, China, 2003"; "Public Health and Aging: Influenza Vaccination Coverage Among Adults Aged >50 Years and Pneumococcal Vaccination Coverage Among Adults Aged >65 Years - United States, 2002"; "Methicillin-Resistant Staphylococcus aureus Infections in Correctional Facilities - Georgia, California, and Texas, 2001-2003"; "West Nile Virus Activity - United States, October 9-15, 2003"; "Notice to Readers: International Conference on Women and Infectious Diseases"; "Notice to Readers: CDC Viral Hepatitis Resource Center Offers Free Materials for Health Professionals and the General Public"; and "Notice to Readers: Publication of Health, United States, 2003 with Chartbook on Trends in the Health of Americans". 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.)
2003-03-28
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Public Health Legal Preparedness Briefing Memorandum #4: Overview of Federal and State Quarantine Authority
"ISSUE: What is the interplay between federal and state quarantine laws? RESPONSE: There are multiple statutory and other legal authorities at the federal and state levels for conducting quarantine during bioterrorism events or other public health emergencies. The extent of authority conferred through these provisions varies extensively. The complexity and inter-working of these provisions are discussed below."
Center for Law and the Public's Health at Georgetown and Johns Hopkins Universities
Sapsin, Jason W.
2003-02-20
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Fact Sheet on Shelter-in-Place
"One of the instructions you may be given in an emergency where hazardous materials may have been released into the atmosphere is to shelter-in-place. This is a precaution aimed to keep you safe while remaining indoors. (This is not the same thing as going to a shelter in case of a storm.) Shelter-in-place means selecting a small, interior room, with no or few windows, and taking refuge there. It does not mean sealing off your entire home or office building. If you are told to shelter-in-place, follow the instructions provided in this Fact Sheet."
American Red Cross
2003-02
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LLIS Best Practice: Crisis Communications Planning: Preparing Communication Mechanisms
"When developing a crisis communications plan, Public Information Officers (PIOs) and Public Affairs Officials (PAOs) should identify a range of communication mechanisms and prepare to use them during an emergency. Multiple communications systems should be used simultaneously in order to reach the widest possible audience. This Best Practice identifies target audiences for different mechanisms, identifies considerations when using specific mechanisms, and reviews the strengths and weaknesses of each mechanism."
Lessons Learned Information Sharing (LLIS)
2003?
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Influence of Global Environmental Change on Infectious Disease Dynamics
"The twentieth century witnessed an era of unprecedented, large-scale, anthropogenic changes to the natural environment. Understanding how environmental factors directly and indirectly affect the emergence and spread of infectious disease has assumed global importance for life on this planet. While the causal links between environmental change and disease emergence are complex, progress in understanding these links, as well as how their impacts may vary across space and time, will require transdisciplinary, transnational, collaborative research. This research may draw upon the expertise, tools, and approaches from a variety of disciplines. Such research may inform improvements in global readiness and capacity for surveillance, detection, and response to emerging microbial threats to plant, animal, and human health."
National Academies Press (U.S.)
2003
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Modeling Shelter-in-Place Including Sorption on Indoor Surfaces
"Intentional or accidental large-scale airborne toxic releases (e.g. terrorist attacks or industrial accidents) can cause severe harm to nearby communities. The purpose of this work is to quantify the level of protection offered by existing houses, and the importance of sorption/desorption to and from surfaces on the effectiveness of SIP."
Lawrence Livermore National Laboratory
Price, Phillip N.; Gadgil, Ashok; Chan, Wanyu R.
2003
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Effectiveness of Shelter-In-Place: Examples from Across the Country
This document shows the effectiveness of sheltering-in-place when chemical emergencies occur. It provides several case studies of chemical emergencies that have occurred throughout the United States. LLIS Core Capability: HazMat; Occupational Safety and Health
National Institute for Chemical Studies (U.S.)
2003-01-01?
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Severe Acute Respiratory Syndrome (SARS): Hearing of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Eighth Congress, First Session on Examining the Status of the Severe Acute Respiratory Syndrome Threat, April 29, 2003
From the opening statement of Judd Gregg: "This is our second major hearing on the issue of the SARS virus and its implications for the United States and our role in trying to abate it as much as possible, certainly here in the United States but also internationally... Unfortunately, it continues to be a rampant problem especially in China. There is, as Dr. Gerberding has said before, no vaccine and right now no antibiotics which appear to be able to be used to limit its impact, and therefore it is important that we identify quickly people who may have symptoms of SARS, especially those coming into the United States. If we identify those individuals, and people self-police themselves as they come back from regions which may have high infection rates, and if they have the sense that they have cold symptoms, they call their medical provider--call them, hopefully, and not go to them--and find out what the next step is. So it is important that American citizens understand that that is their obligation as good citizens to pursue that course of action. Today we are going to hear from Dr. Gerberding, who is head of CDC and is doing an extraordinary job for us on this issue and many other issues. We are also going to hear from Dr. Gully, from Health Canada, which is the national health organization in Canada, and Dr. Young, who is with the province of Ontario and is involved in the fight there." Statements, letters, and materials submitted for the record include those of the following: Judd Gregg, Julie Gerberding, Paul Gully, James G. Young, Senator Johnson, and Samuel Wallace.
United States. Government Printing Office
2003
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Serial No. 108-9: SARS Threat: Is the Nation's Public Health Network Prepared for a Possible Epidemic? Hearing before the Committee on Government Reform, House of Representatives, One Hundred Eighth Congress, First Session, April 9, 2003
From the opening statement of Tom Davis: "The SARS [Severe Acute Respiratory Syndrome] threat is the first challenge to our Nation's health network capabilities. It provides us with a chance to evaluate existing procedures and safeguards. SARS has brought fear and confusion to everyone's lives, particularly international travelers, airline crews and health care workers. Currently there is no known cure and the disease is easily communicable. In a precautionary effort to prevent further spread of the disease, President Bush signed an Executive order on Friday, April 4, authorizing the use of quarantine if necessary. The President's unprecedented actions prove how serious the threat of SARS epidemic is to our country. SARS is believed to have originated in China in the fall of 2002. It has since spread to 17 countries. As of today there have been over 2,600 SARS cases reported worldwide, with 98 deaths. In the United States the number of cases continues to rise. Today this country has approximately 148 suspected cases in 30 different States, with the highest concentrations in New York and California. Fortunately, no deaths have been reported. We've actually seen two suspected cases of SARS nearby in northern Virginia. I'm pleased that we'll hear testimony from the director of the Loudoun County Health Department, who is responsible for the treatment of a SARS patient in early February." Statements, letters, and materials submitted for the record include those of the following: Janet Heinrich, Tommy G. Thompson, Lacy Clay, Tom Davis, David Goodfriend, and Margaret Hamburg.
United States. Government Printing Office
2003
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Consensus Document on the Epidemiology of Severe Acute Respiratory Syndrome (SARS)
From the Introduction: "On 16-17 May 2003, the World Health Organization [WHO] held the first global meeting on the epidemiology of SARS [severe acute respiratory syndrome] in Geneva, Switzerland. The objectives of the meeting were to: [1] Produce a WHO consensus document on our current understanding of the epidemiology of SARS as it informs public health practice. [2] Identify gaps in our knowledge for the planning of additional epidemiological studies if required. There are still considerable gaps in our knowledge of the global epidemiology of SARS, which is the first severe and readily transmissible new disease to emerge in the twenty-first century. WHO is coordinating the synthesis and interpretation of the body of work that is being produced around the world and is promoting the sharing of data and experience in containing and controlling this epidemic."
World Health Organization
2003
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Emerging Issues in Water and Infectious Disease
"Infectious, water-related diseases are a major cause of morbidity and mortality worldwide. Although a significant proportion of this immense burden of disease is caused by 'classical' water-related pathogens, such as typhoid and cholera, newly-recognized pathogens and new strains of established pathogens are being discovered that present important additional challenges to both the water and public health sectors. Whilst many of these organisms are associated with diseases that have been known for many years, a small but significant percentage are associated with emerging diseases, such as Acquired Immunodeficiency Syndrome (AIDS), Ebola and most recently Severe Acute Respiratory Syndrome (SARS). Indeed, the transmission of the coronavirus responsible for SARS through 'faecal droplets' has re-focused attention on this recognized route of transmission of some viruses. The transmission of the coronavirus responsible for Severe Acute Respiratory Syndrome (SARS) through 'faecal droplets' has re-focused attention on this recognized route of transmission of some viruses. This document reviews what is known about viruses transmitted by this route and the adequacy of control measures, including building design and management, and plumbing practices." "
World Health Organization
2003
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S. Hrg. 108-139: Global HIV/AIDS and Severe Acute Respiratory Syndrome (SARS): Hearing before a Subcommittee of the Committee on Appropriations, United States Senate One Hundred Eighth Congress, First Session, Special Hearing, April 8, 2003
This hearing discusses what the National Institute of Health and the Center for Disease Control are doing to keep AIDS and SARS from growing. Gerberding: "The two main things that we are doing right now to prevent transmission are, number one, alerting travelers that when they return to the United States, that they should see a doctor if they are ill within 10 days of their arrival. And second, we are alerting all clinicians that if they see a patient with an unexplained respiratory illness who has traveled to Asia or other areas where this is endemic, that they need to think about SARS and isolate the patient until they have evidence to suggest that this is not the case. So this is a global emerging infectious disease. We see this pattern of emergence time and time again. But this one is particularly noteworthy because it does appear, at least in some cases, to spread very efficiently from person to person. We learned our lesson with HIV infection. And if I can show the next graphic, the President in his 2004 budget made an announcement about an extremely important global HIV initiative, to really prevent HIV and to provide care and treatment to the some 40 million people internationally who have this condition. CDC has a very important role to play in this. We have $294 million in the President's 2004 request for our global AIDS programs, in particular for the maternal to child transmission prevention work that we will be doing in 14 countries, in Africa, in the Caribbean, and in Asia." Statements for the record include those of: Julie Gerberding, Elias Zerhouni, Anthony S. Fauci, Thad Cochran, and Arlen Specter.
United States. Government Printing Office
2003
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Serial No. 108-20: SARS: Assessment, Outlook, and Lessons Learned: Hearing before the Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce, House of Representatives One Hundred Eighth Congress, First Session, May 7, 2003
Serial No. 108-20: The main purpose of this hearing is "the clear need to continue our vigilance in the fight against SARS to determine whether we are appropriately prepared for any possible SARS upsurge, especially next winter, and to identify where we might improve public health response for future deadly infectious disease outbreaks or bioterrorism attacks. Is SARS a harbinger of the eventual pandemic the disease experts warn we must be prepared to face? It certainly has focused our attention on broader questions of preparedness which at, present fortunately, have not been put to the test. How would we handle large infection rates or isolate and treat infected people? Is our hospitalization infrastructure prepared? Do public health laws measure up to the realities of the day? And what about gaps in international and local surveillance? Will we be able to develop vaccines and other treatments? Do we have the resources? Are we proceeding now to enhance our overall ability to battle infectious outbreaks?" The panel of witnesses at this hearing provide authoritative information on the actions taken in response to SARS and related planning for future outbreaks. Testimony, statements and additional materials submitted for the record include those of the following persons: Georges C. Benjamin, Barry R. Bloom, Denis R. Burger, Robert J. Capetola, Anthony S. Fauci, Paul H. Fischer, Julie L. Gerberding, Jerome M. Hauer, Janet Heinrich, James G. Hodge, Jr., Karin Kerby, Nils Lonberg, Murray Lumpkin, Jared N. Schwartz, and John M. Brenna. An archived webcast of this hearing is available at: http://energycommerce.house.gov/108/Hearings/05072003hearing917/hearing.htm
United States. Government Printing Office
2003
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Preparedness Planning for State Health Officials: Nature's Terrorist Attack: Pandemic Influenza
"Almost a century after the Spanish flu, the United States remains unprepared for pandemic influenza, an event which could affect an extraordinary number of people and last more than a year. It remains a challenge to convey the potential severity of a pandemic to key law and policymakers, as well as individuals in the medical and public health communities...The following checklist provides state health officials with a preliminary means of assessing their jurisdictions' readiness to respond to a pandemic. The checklist is not exhaustive, but identifies major issues that each state will need to address during a pandemic. The list also differentiates between issues that are specific to pandemic influenza and those that have broader utility for public health emergency preparedness. The overlap demonstrates why state health officials have an unprecedented opportunity, using their bioterrorism assessments and plans as scaffolding, to help create strategies that will improve their states' response to future pandemics. The full report offers a more comprehensive description of the challenges involved in pandemic planning and response."
Association of State and Territorial Health Officials (U.S.)
2002-11
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Burden of Infectious Disease Among Inmates of and Releasees from US Correctional Facilities, 1997
From the Methods: "In this study we developed national estimates of the prevalence of selected infectious diseases among prison and jail inmates during 1997, then applied these percentages to the number of persons incarcerated on June 30, 1997, to estimate the number of inmates with each condition. Next, we applied the prevalence percentages for inmates to the total number of people released from correctional facilities during 1997 to yield an estimate of the number of releasees with each condition. Finally, we calculated the percentages of the total number of people with these conditions in the United States found among correctional releasees in 1997."
American journal of public health (New York, N.Y. : 1971)
Hammett, Theodore M.; Harmon, Mary Patricia; Rhodes, William
2002-11
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Planning Protective Action Decision-Making: Evacuate Or Shelter-In-Place?
"Deciding whether to evacuate or to shelter-in-place is one of the most important questions facing local emergency planners responding to a toxic chemical release. That such a complex decision with such important potential consequences must be made with such urgency places tremendous responsibility on the planners and officials involved. Researchers have devoted considerable attention to the evacuation/shelter-in-place protection decision. While several decision aids have been developed, no single approach has achieved widespread acceptance based on validity, utility, and effectiveness (Ujihara 1989, Mannan and Kilpatrick 2000). In the absence of an agreed-upon methodology for making this decision, the best strategy for local emergency planners and officials is a thorough understanding of all the components affecting the decision. This paper summarizes what is currently known about the evacuation/shelter-in-place protection decision and points to available literature that more thoroughly explores the individual components of the decision. The next section summarizes the major issues in protective action decision process. This is followed by a discussion of all the factors that may bear on the protective action decision process. The final section address how to make a protective action decision."
Oak Ridge National Laboratory
Sorensen, John H.; Vogt, Barbara M.; Shumpert, Barry
2002-06
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Pandemic Influenza Preparedness Plan for Maryland - Version 5
The purpose of this plan is to "provide procedures for mitigating the consequences of an influenza pandemic affecting Maryland."
Maryland. Department of Health and Mental Hygiene
2002-04
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Temporary Shelter-in-place as Protection Against a Release of Airborne Hazardous Material: Report of a Literature Search
"'Temporary shelter-in place' is the combination of prompt shelter-in-place (SIP) to minimize initial exposure to airborne hazardous material, followed by timely action to terminate this protection to minimize exposure to hazardous vapor accumulations in the shelter once the air outside becomes less hazardous than the air inside the shelter. [...] Temporary SIP, if properly executed, is considered to be an effective way to protect populations from hazardous chemical vapors, especially from high concentrations for short periods. This is supported by laboratory and field experiments. The need for timely termination of temporary SIP as protection from infiltrated vapors is an integral component of a temporary SIP strategy. It was from this premise that Argonne National Laboratory (ANL) was asked to develop methodologies for deciding when and how to terminate SIP. These methodologies, in turn, could be the basis for site-specific operational guidelines (e.g., decision matrix, decision-tree, or algorithm) for terminating SIP on each of the eight Army chemical stockpile storage sites, and in the off-post communities surrounding them."
Argonne National Laboratory. Decision and Information Sciences Division; United States. Department of Energy
Yantosik, George; Lerner, Ken; Maloney, D.M.
2002-03-16
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Animal Disease Surveillance: A Framework for Supporting Disease Detection in Public Health
Animal disease surveillance can serve as sentinels for bioterrorist or natural infectious disease epidemics. As such, it is important to understand how animal disease affects humans and how this information can be obtained and
monitored on a regular and timely basis.
Scientific Technologies Corporation
Wurtz, Rebecca; Popovich, Michael
2002-03
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State Emergency Preparedness and Response Inventory: A Tool for Rapid Assessment of State Capacity to Respond to Bioterrorism, Other Outbreaks of Infectious Disease and Other Public Health Threats and Emergencies
"The Emergency Preparedness and Response Inventory (EPRI) provides a rapid assessment of a public health agency's ability to respond to public health threats and emergencies. The Inventory includes measures to assess progress towards meeting the benchmarks and critical and enhanced capacities described in the grant guidance for Fiscal Year 2002 Supplemental Funds for Public Health Preparedness and Response to Bioterrorism (Announcement Number 99051)."
Centers for Disease Control and Prevention (U.S.)
2002-02
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Protecting the Nation's Health in an Era of Globalization: CDC's Global Infectious Disease Strategy
This booklet discusses the US role in identifying and preventing infectious diseases at home and abroad in the current era of globalization. Topics covered include international cooperation in combating infectious diseases, protection of US citizens at home and abroad, humanitarian aid, future strategy, partnerships, priorities and objectives as they pertain to outbreaks, disease surveillance, public health, and training, and a number of additional resources such as websites, collaborating centers, and surveillance networks. The Center for Disease Control (CDC) has increased its presence overseas due to the increasing nature of globalization which increases the risks of disease throughout the world. This document discusses some diseases such as HIV/Aids, Tuberculosis (TB), Malaria, West Nile Virus, Polio, Salmonella, etc. A number of factors have been identified in the causes of disease spread; globalization of the food supply (especially fresh produce), import of "ethnic" foods to the US, and international travel. The CDC is developing partnerships at home and abroad to research new and emerging diseases and "old" diseases that were thought to be eradicated. These partnerships will aid in the identification of potential outbreaks and help control and isolate an outbreak. This booklet contains an extensive list of other health agencies throughout the world and a list of the international assistance the CDC provided throughout the 1990s.
National Center for Infectious Diseases (U.S.)
2002
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Rapid Deployment of an Electronic Disease Surveillance System in the State of Utah for the 2002 Olympic Winter Games
"The key to minimizing the effects of an intentionally caused disease outbreak is early detection of the attack and rapid identification of the affected individuals. The spirit of collaboration and unity inspired by the events of 9-11 and the 2002 Olympic Winter Games in Salt Lake City provided the opportunity to demonstrate how a prototypic biosurveillance system could be rapidly deployed. In seven weeks we were able to implement an automated, real-time disease outbreak detection system in the State of Utah and monitored 80,684 acute care visits occurring during a 28-day period spanning the Olympics. No trends of immediate public health concern were identified."
University of Pittsburgh
Wagner, Michael M.; Chapman, Wendy Webber; Gesteland, Per
2002
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Scenario Analysis of the Expected Number of Hospitalisations and Deaths Due to Pandemic Influenza in the Netherlands
"Another influenza pandemic, following those of 1918, 1957, and 1968, is likely, if not inevitable. In a regular influenza epidemic, 5%-20% of the population becomes clinically ill; during a pandemic, this percentage can mount to 30% or even 50%. A pandemic could cause substantial social disruption, insofar as it would involve a large proportion of the population contracting a serious or less serious form of the illness. In order to minimise the effects of such a potential pandemic on the population, the Dutch Ministry on Health, Welfare and Sport has drawn up an influenza pandemic contingency plan to be prepared to cope with mass illness and the burden on the health care services. The objective of this study is to calculate the expected numbers of hospital admissions and deaths in case of an influenza pandemic. As many uncertainties are involved in this type of studies, we have developed alternative scenarios and consulted experts for their opinions on these scenarios and on the underlying model and assumptions. The effects of the intervention scenarios are compared in terms of preventing hospitalisation and mortality. Possible intervention strategies are vaccinations against influenza or pneumococcal infections (one of the possible complications of influenza) of certain groups or the prescription of antiviral medicine (within 48 hours after the first symptoms) for each person with an influenza-like illness."
Netherlands. Ministerie van Volksgezondheid en Milieuhygiëne
2002
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Shelter in Place or Evacuate? That is the Question!
"Chemical releases and accidents involving gasoline, oil, paints and other hazardous materials could cause a wide range of serious injuries and possibly death from exposure to vapors, fumes and smoke. Sometimes, local officials may ask the public to protect themselves by staying inside their homes, cars and offices. At other times, local officials may order an evacuation. This special ESP Bulletin provides some basic preparedness tips and explains the difference between these two protective measures."
California. Governor's Office of Emergency Services
2002
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Report of the Shelter-in-Place Work Group
"This report has been prepared by the Shelter-in-Place Work Group (SIPWG) for the Chemical Stockpile Emergency Preparedness Program (CSEPP). Created during the December 2000 CSEPP Planning Conference held in Dallas, TX, the SIPWG was specifically formed to address four topics that were identified by conference participants as critical unresolved planning issues in CSEPP. The planning community defined these issues as the following: 1.) Evacuation vs. sheltering; 2.) How should an all-clear be sounded for people sheltered in place?; 3.) Policy for egress from Shelter-in-Place; 4.) Handling of people after leaving shelter (decontamination, transportation) [.] At the first meeting of the SIPWG in February 2001, these four issues were consolidated to three taskings by Joe Herring of Federal Emergency Management Agency (FEMA) Headquarters as follows: 1.) How to develop an approach to Protective Action Recommendation (PAR)/Protective Action Decision (PAD) decision-making; 2.) When and how a sheltered population should end a shelter in-place protective action; 3.) How to handle or process populations that shelter-in-place [.]" From the Purpose: "The purpose of this report is to address critical unresolved planning issues identified by CSEPP planners in December 2000 related to using Shelter-in-Place (SIP) as a protective action strategy. It identifies best practices, and recommends changes and additions to CSEPP's published planning guidance and policies."
United States. Federal Emergency Management Agency; United States. Army
2001-12-03
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Shelter-In-Place
This presentation provides an overview concept of Sheltering-In-Place. It presents several sheltering-in-place strategies, different infiltration and protections in sheltering-in-place, an overview of public compliance for sheltering-in-place, and sheltering-in-place effectiveness.
United States. Department of Energy
Sorensen, John H.
2001-12
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Public Law 107-47: Defense Production Act Amendments of 2001
"An act to extend the expiration date of the Defense Production Act of 1950, and for other purposes"
United States. Government Printing Office
2001-10-05
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Model Emergency Response Communications Planning for Infectious Disease Outbreaks and Bioterrorist Events
"The first edition of this planning tool was released in May 2000. Following the attacks of September 11, 2001, and subsequent release of anthrax spores, a second edition was warranted. This edition contains updated information and includes Infectious Disease Fact Sheets that can be modified and reproduced for local use. While state and federal agencies have deemed public health preparedness to respond to infectious disease and bioterrorism threats essential to safeguard the nation's well-being, the resources needed to support such planning efforts have not always been available. Recent events, however, have yielded compelling arguments to commit the resources necessary to develop and maintain strong public health infrastructures with systems prepared to respond immediately to biologic and chemical attacks that threaten the public health. ASTDHPPHE [Association of State and Territorial Directors of Health Promotion and Public Health Education] and its partners hope that the information provided in this document will advance that goal. The expertise of health education and health communication specialists is paramount in emergency preparedness efforts. They possess unique skills for communicating messages to forestall panic and public anxiety while increasing awareness of threatening agents and complex processes. Moreover, these practitioners are accustomed to focusing outreach efforts in ways that reach specific populations in varying settings across the country. They can assist in ensuring that vital messages reach the most vulnerable."
Association of State and Territorial Directors of Health Promotion and Public Health Education
2001-10
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Model Emergency Response Communications Planning for Infectious Disease Outbreaks and Bioterrorist Events, Second Edition
"The first edition of this planning tool was released in May 2000. Following the attacks of September 11, 2001, and subsequent release of anthrax spores, a second edition was warranted. This edition contains updated information and includes Infectious Disease Fact Sheets that can be modified and reproduced for local use. While state and federal agencies have deemed public health preparedness to respond to infectious disease and bioterrorism threats essential to safeguard the nations well-being, the resources needed to support such planning efforts have not always been available. Recent events, however, have yielded compelling arguments to commit the resources necessary to develop and maintain strong public health infrastructures with systems prepared to respond immediately to biologic and chemical attacks that threaten the public health. ASTDHPPHE and its partners hope that the information provided in this document will advance that goal."
Association of State and Territorial Health Officials (U.S.)
2001-10
