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Questions and Answers Regarding Actions To Take When Ending Shelter-In-Place
"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
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Georgetown University Medical Center Evacuation and Shelter-in-Place Plan
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
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Hungarian National Plan for the Pandemic Preparedness to Influenza (Interim Working Document)
"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
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Hungarian National plan for the pandemic preparedness to influenza
National pandemic preparedness plan of Hungary.
Hungary. National Center for Epidemiology
2003-09
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SARS (Severe Acute Respiratory Syndrome): Down But Still a Threat
"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
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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
"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
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Contact Tracing for SARS - Then and Now
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
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Norwegian National Influenza Pandemic Preparedness Plan
"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
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After Action Report: SARS Complaint, Mid-Continent Airport, Wichita, KS, June 12, 2003
"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
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After-Action Report: SARS Complaint, Mid-Continent Airport, June 12, 2003
This brief after-action report outlines the response to a suspected severe acute respiratory syndrome (SARS) case at the Mid-Continent Airport in Wichita, Kansas. The document provides a timeline of events and offers lessons learned.
Sedgwick County Emergency Management
2003-06-19?
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Guidelines on the Prevention and Management of Severe Acute Respiratory Syndrome (SARS)
The World Health Organization International Health Regulations (IHR) contain provisions regarding routine point of entry control activities and specific measures for some diseases. In addition, the IHR reference technical guides for both ships and aircraft. The SARS outbreak, like other international disease outbreaks that occur around the world from time to time, requires that crew have a basic understanding of the disease, the risks and the public health precautions necessary for both passenger and crew protection. The information in this memo, like the Guide to Hygiene and Sanitation in Aircraft and the Guide to Ship Sanitation, is provided as a technical reference for the development of operating procedures by international passenger transport companies. Although this information is provided for use by international ship and aircraft operators, it can apply, as appropriate, to other means of travel.
International Maritime Organization
2003-06-16
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SARS (Severe Acute Respiratory Syndrome) Coronavirus: a New Challenge for Prevention and Therapy
"A new and deadly clinical syndrome now called severe acute respiratory syndrome (SARS) was brought to the attention of the WHO by Dr. Carlo Urbani and his colleagues in a Vietnamese hospital in February 2003 (1). The WHO, the medical staffs in hospitals where the disease had appeared, and local and regional governments, together with a dozen cooperating laboratories across the globe, immediately responded. They provided a provisional case definition to identify the extent and geographic distribution of the outbreak (2), laboratory investigations to identify the infectious agent, and travel advisories and quarantines to limit the spread of the disease (3, 4). This extraordinary and effective collaboration limited the potentially explosive spread of the outbreak, while initial case reports with clinical and epidemiological information were quickly posted on the Internet to help physicians identify additional cases of the new syndrome (2, 4-9)...Laboratory investigations using electron microscopy, virus-discovery microarrays containing conserved nucleotide sequences characteristic of many virus families, randomly primed RT-PCR, and serological tests quickly identified the virus as a new coronavirus (8, 10, 11). Inoculation of monkeys with the SARS-associated coronavirus (SARS-CoV) caused interstitial pneumonia resembling SARS, and the virus was isolated from the nose and throat (12). No viral or bacterial copathogen was needed to induce the disease. These experiments fulfilled Koch's postulates and proved that SARS-CoV is the cause of SARS."
American Society for Clinical Investigation
Holmes, Kathryn V.
2003-06
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SARS: How Effective is the State and Local Response? Hearing Before the Permanent Subcommittee on Investigations of the Committee on Governmental Affairs, United States Senate, One Hundred Eighth Congress, First Session, May 21, 2003
This is the May 21, 2003 hearing on "SARS: How Effective is the State and Local Response?" held before the U.S. Senate Committee on Governmental Affairs. From the opening statement of Norm Coleman: "When a new disease such as SARS or the West Nile virus hits local communities, several things have to happen. First, local doctors need to know how to recognize that something new is happening and need to know who to turn to for information and support. Second, at the national and international levels, agencies must quickly develop information about the characteristics of the disease in order to treat patients and prevent its spread. The World Health Organization, the National Institutes for Health, and the Centers for Disease Control and Prevention perform this role well. Third, and this is most important, in my opinion, the information these agencies develop must be transmitted back to mayors, hospital administrators, and airport officials so that doctors, airline attendants, researchers, and average citizens know what to do in order to protect themselves. In the end, our goal ought to be to develop a national response, predicated on the understanding that the bulwark of that response is going to be at the local level--and by local government and elected officials. And that they must have the resources and the cooperation of the Federal Government to do so." Statements, letters, and materials submitted for the record include those of the following: Julie L. Gerberding, Anthony S. Fauci, Michael T. Osterholm, Rodney N. Huebbers, Thomas R. Frieden, Mary C. Selecky, Lawrence O. Gostin, Bruce R. Cords, and Vicki Grunseth.
United States. Government Printing Office
2003-05-21
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Researching SARS
This piece from the News Hour with Jim Lehrer looks at how scientific research is contributing to the struggle against SARS. Various scientists from the National Institutes of Health and the CDC are interviewed. A transcript, as well as streaming audio and video files are available. Originally broadcast on May 20, 2003. (Media files are available in Windows Media and Real Video/Audio formats.)
Public Broadcasting Service (U.S.)
Fauci, Anthony S.
2003-05-20
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Bio-Terrorism & SARS
The world has been whipped up into hysteria over terrorist attacks and weapons of mass destruction'. Governments want to ban the publication of sensitive scientific research results, and a group of major life sciences editors and authors has concurred. Some even suggest an international body to police research and publication. In this document, Dr. Mae-Wan Ho looks at the current SARS epidemic and argues why all of those measures to control bio- terrorism are misplaced, and what's really needed.
GM Science Review
Ho, Mae-Wan.
2003-05-14
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Dangerous Secrets--SARS and China's Healthcare System: Roundtable before the Congressional-Executive Commission on China, One Hundred Eighth Congress, First Session, May 12, 2003
In the case of Severe Acute Respiratory Syndrome [SARS], mainland China has reported more than 4,600 cases and over 219 deaths from the disease. Recent news articles report that over 16,000 people are now under quarantine in Beijing, and thousands more in Nanjing and elsewhere. These massive quarantine measures are becoming commonplace throughout China in the country's increasingly stringent efforts to control the epidemic. While the number of cases in the rest of the world seems to be stabilizing or possibly even decreasing, China's caseload continues to increase as the disease spreads into the country's interior. A problem particular to China is that migrant workers, alarmed by the rise of the disease in the cities, have shown a tendency to head home to poverty-stricken inland provinces in hopes of avoiding infection. In some cases, of course, they are bringing the illness with them. In a recent statement, Premier Wen Jiabao warned that the country's rural healthcare system is weak and might prove incapable of handling a SARS epidemic in the countryside. Some observers are now asking whether the public health system, already stretched thin by the central government attempts to shrink local government budgets, will simply collapse under the weight of SARS and the oncoming tidal wave of HIV/AIDS.
United States. Government Printing Office
2003-05-12
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SARS Outbreak: Improvements to Public Health Capacity Are Needed for Responding to Bioterrorism and Emerging Infectious Diseases: Testimony of Janet Heinrich, Director, Health Care--Public Health Issues before the Subcommittee on Oversight and Investigations, Committee on Energy and Commerce, House of Representatives
The efforts of public health agencies and health care organizations to increase their preparedness for major public health threats such as bioterrorism and the worldwide influenza outbreaks known as pandemics have improved the nation's capacity to respond to SARS and other emerging infectious disease outbreaks, but gaps in preparedness remain. Specifically, GAO found that there are gaps in disease surveillance systems and laboratory facilities and that there are workforce shortages. GAO found that planning for regional coordination was lacking between states. GAO also found that states were developing plans for receiving and distributing medical supplies for emergencies and for mass vaccinations in the event of a public health emergency. GAO found that most hospitals lack the capacity to respond to large-scale infectious disease outbreaks. Most emergency departments have experienced some degree of crowding and therefore in some cases may not be able to handle a large influx of patients during a potential SARS or other infectious disease outbreak. Most hospitals across the country reported participating in basic planning activities for such outbreaks. However, few hospitals have adequate medical equipment, such as the ventilators that are often needed for respiratory infections such as SARS, to handle the large increases in the number of patients that may result. The public health response to outbreaks of emerging infectious diseases such as SARS could be improved by the completion of federal and state influenza pandemic response plans that address problems related to the purchase, distribution, and administration of supplies of vaccines and antiviral drugs during an outbreak.
United States. General Accounting Office
2003-05-07
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Severe Acute Respiratory Syndrome (SARS)
The spread of SARS is not limited to air travel. Thousands of ships ply every day between ports, carrying with them seafarers from all nations. Cruise ships, ferries and passenger liners in particular carry large number of passengers and crew on each ship. Should any crew or passenger on board be infected with SARS, the disease could spread quickly on the ship to many persons. This is especially so on a passenger ship. There is therefore an urgent need for the international shipping community to appreciate the potential danger of the spread of SARS through sea travel and to take the necessary steps to prevent any spread. Countries should be ready to handle incidents of SARS on ships in their ports or arriving in their ports. The bulk of the world seaborne trade is carried by ships and all countries. This document addresses the results of consultations between the Secretary-General and the Chairman of the Maritime Safety Committee concerning SARS.
International Maritime Organization
2003-05-06
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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, May 2, 2003
From the opening statement of Arlen Specter: "The world is now suffering from an enormous problem of SARS, originated in China, has been a problem in many parts of the world, recently in Toronto and also in the Lehigh Valley in Pennsylvania… We are calling upon the Centers for Disease Control to undertake enormous new responsibilities to prepare for potential bioterrorism, and SARS is an unexpected problem; but when we take a look at the funding for the Centers for Disease Control, it is really totally inadequate not to use other language which might be more expressive or more emphatic, but the Centers for Disease Control was cut by some $175 million this year." This hearing focuses on is what is happening now on the containment of SARS, what is happening with the problem posed in China, limitations as to where people can travel and quarantines, what is going to happen in the future and what we need to do to have an adequate system to deal with problems like this one, and the adequacy of funding for the Centers for Disease Control in responding to such unexpected problems as SARS. Witnesses, statements and submissions: Julie Gerberding, Arlen Specter, Luther Rhodes, Anthony Fauci, and John Combes.
United States. Government Printing Office
2003-05-02
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S. Hrg. 108-136: 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 May 2, 2003
On May 2, 2003, the Senate Severe Committee on Appropriations convenes to discuss and hear testimony regarding Acute Respiratory Syndrome (SARS). Testifying are Julie Gertberding, MD, Ph.D., of the Centers for Disease Control and Prevention, Luther Rhodes MD of the Lehigh Valley Hospital Division of Infectious Disease, Anthony Fauci, MD, of the National Institutes of Health, and Dr. John Combes of the Hospital and Health System Association of Pennsylvania. Chairman Arlen Spector explains that "The world is now suffering from an enormous problem of SARS, originated in China, has been a problem in many parts of the world, recently in Toronto and also in the Lehigh Valley in Pennsylvania." He adds, "it is difficult to say this, but the Centers for Disease Control is in a dilapidated state". Julie Gerberding testifies that "the Chinese Government was unwilling to provide the information to the global health communities for quite some time. I think initially they misunderstood the problem as being caused by chlamydia infection or some other infectious disease" and that "we need a global system for detecting and diagnosing and responding to emerging infectious disease threats." Dr. Fauci states that "I think at the present time given the burden of cases that we have now, the level of alertness that we have been put on, the measures that the CDC has taken in surveillance and public health and infection control, that the risk is relatively small."
United States. Government Printing Office
2003-05-02
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SARS: Need for Security Priority
"While the threat of Severe Acute Respiratory Syndrome (SARS) continues to spread across the globe, many countries have been bracing themselves to cope with one of the worst health epidemics that have hit several parts of the world. To date, SARS has spread to 28 countries with 7, 864 infected cases and 642 deaths. With no known cure in sight, medical teams have been working feverishly to contain the problem as the clock ticks away with more reported casualties, while government authorities have been deploying various strategies to cope with the silent killer. In the Asian region, hard-hit Asian governments have quickly set in place mechanisms to prevent further the spread of the disease.These mechanisms ranged from quarantine of infected patients including their families and friends who may have had close contacts with them, issuing travel advisories to SARS-affected countries, strict immigration checks and border controls, massive public information programme and even closure of schools. Singapore, one of the badly hit countries in Southeast Asia, has been commended for its hands-on, pro-active approach in containing the disease--even to point of adopting stringent quarantine measures labelled by some media as 'draconian'."
Complutense University of Madrid. Research Unit on International Security and Cooperation (UNISCI)
Anthony, Mely Caballero
2003-05
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SARS: A Need for Security
"While the threat of Severe Acute Respiratory Syndrome (SARS) continues to spread across the globe, many countries have been bracing themselves to cope with one of the worst health epidemics that have hit several parts of the world. To date, SARS has spread to 28 countries with 7, 864 infected cases and 642 deaths. With no known cure in sight, medical teams have been working feverishly to contain the problem as the clock ticks away with more reported casualties, while government authorities have been deploying various strategies to cope with the silent killer. In the Asian region, hard-hit Asian governments have quickly set in place mechanisms to prevent further the spread of the disease. But while Singapore and the other affected countries were prompt to act, some were not. China, for example, had been severely criticised for initially playing down the seriousness of the problem and its delayed response. In particular, in what seemed to be the height of the outbreak, China was censured for its slowness to respond to the request by the World Health Organisation (WHO) to allow its medical team to go to Guangdong where the infectious pathogen was said to have started."
Complutense University of Madrid. Research Unit on International Security and Cooperation (UNISCI)
Anthony, Mely Caballero
2003-05
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S. Hrg. 108-120: SARS: Best Practices for Identifying and Caring for New Cases: Hearing before the Permanent Subcommittee on Investigations of the Committee on Governmental Affairs, United States Senate, One Hundred Eighth Congress, First Session, July 30, 2003
This is the second in a series of hearings by this Subcommittee aimed at helping the Nation respond to the threat of SARS. At the first hearing on May 21, the Subcommittee heard testimony from a number of witnesses at the national, State, and local levels. This hearing addresses a survey undertaken by the General Accounting Office of best practices for identifying and treating SARS. Also addressed are the efforts of the Centers for Disease Control and Prevention to properly inform and work with local agencies regarding SARS. The hearing also discusses national and regionally plans for dealing with SARS, especially if there is a large-scale outbreak, and the adequacy of the health care system to respond to an outbreak. Statements, witnesses and submissions include those of: Norm Coleman, Carl Levin, Susan Collins, Mark Pryor, Frank Lautenberg, Marjorie Kanof, and James Hughes.
United States. Government Printing Office
2003-04-30
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Emerging Infectious Diseases: Asian SARS Outbreak Challenged International and National Responses, Report to the Chairman, Subcommittee on Asia and the Pacific, Committee on International Relations, House of Representatives
"Severe acute respiratory syndrome (SARS) emerged in southern China in November 2002 and spread rapidly along international air routes in early 2003. Asian countries had the most cases (7,782) and deaths (729). SARS challenged Asian health care systems, disrupted Asian economies, and tested the effectiveness of the International Health Regulations. GAO was asked to examine the roles of the World Health Organization (WHO), the U.S. government, and Asian governments (China, Hong Kong, and Taiwan) in responding to SARS; the estimated economic impact of SARS in Asia; and efforts to update the International Health Regulations. GAO is recommending that the Secretaries of Health and Human Services (HHS) and State work with WHO and other member states to strengthen WHO's global infectious disease network. GAO is also recommending that the Secretary of HHS complete steps to ensure that the agency can obtain passenger contact information in a timely manner, including, if necessary, the promulgation of specific regulations; and that the Secretary of State work with other relevant agencies to develop procedures for arranging medical evacuations during an airborne infectious disease outbreak. HHS, State, and WHO generally concurred with the report's content and its recommendations."
United States. General Accounting Office
2003-04-28
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Infectious Disease Outbreaks: Bioterrorism Preparedness Efforts Have Improved Public Health Response Capacity, but Gaps Remain: Testimony of Janet Heinrich, Director, Health Care--Public Health Issues, before the Committee on Government Reform, House of Representatives
This statement by Janet Heinrich, Director, Health Care--Public Health Issues discusses the work being done pertaining to the United States' preparedness to manage major public health threats. The initial response to an outbreak of infectious disease would occur at the local level, with support from the state, whether the outbreak was naturally occurring or due to the intentional release of a harmful biological agent by a terrorist. Just as in a bioterrorist attack, a naturally occurring outbreak could involve public health officials in disease surveillance, epidemiologic investigation, health care delivery, and quarantine management. To assist the Committee in its consideration of US capacity to respond to a major public health threat, remarks focus on (1) the preparedness of state and local public health agencies for responding to a large-scale infectious disease outbreak, (2) the preparedness of hospitals for responding to a large-scale infectious disease outbreak, and (3) federal and state efforts to prepare for an influenza pandemic.
United States. General Accounting Office
2003-04-09
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S. Hrg. 108-136: Severe Acute Respiratory Syndrome Threat (SARS): Hearing before the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Eighth Congress, First Session on Examining the Severe Acute Respiratory Syndrome Threat, Focusing on the Issues of Vaccine Development, Drug Screening, and Clinical Research, April 7, 2003
The purpose of this hearing is to address the threat of SARS. It looks at the roles of the Centers for Disease Control and the National Institute of Health in combating and containing communicable diseases, as well as resources and ability to protect the country in the event of a bioterrorist attack. Witnesses, statements and submissions: Judd Gregg, Edward Kennedy, Julie Gerberding, Anthony Fauci, David Heymann, and Christopher Dodd.
United States. Government Printing Office
2003-04-07
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Executive Order 13295: Revised List of Quarantinable Communicable Diseases
This executive order provides a revision of the list of quarantinable communicable diseases. Diseases include cholera; diphtheria; infectious Tuberculosis; Plague; Smallpox; Yellow Fever; Viral Hemorrhagic Fevers; and Severe Acute Respiratory Syndrome.
United States. Office of the Federal Register
Bush, George W. (George Walker), 1946-
2003-04-04
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Enabling Analytical and Modeling Tools for Enhanced Disease Surveillance
Early detection, identification, and warning are essential to minimize casualties from a biological attack. For covert attacks, sick people are likely to provide the first indication of an attack. An enhanced medical surveillance system that synthesizes distributed health indicator information and rapidly analyzes the information can dramatically increase the number of lives saved. Current surveillance methods to detect both biological attacks and natural outbreaks are hindered by factors such as distributed ownership of information, incompatible data storage and analysis programs, and patient privacy concerns. Moreover, because data are not widely shared, few data mining algorithms have been tested on and applied to diverse health indicator data. This project addresses both integration of multiple data sources and development and integration of analytical tools for rapid detection of disease outbreaks. The first prototype developed included an application to query and display distributed patient records. This application incorporated need-to-know access control and incorporated data from standard commercial databases. Two different algorithms were developed and tested for outbreak recognition. The first is a pattern recognition technique that searches for space-time data clusters that may signal a disease outbreak. The second is a genetic algorithm to design and train neural networks (GANN) applied toward disease forecasting. These algorithms were tested against influenza, respiratory illness, and Dengue Fever data.
Sandia National Laboratories
Koch, Mark W.; McKenna, Sean A., Ph. D.; Bilisoly, Roger L.
2003-04
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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
