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Mental Health and Behavioral Guidelines for Response to a Pandemic Flu Outbreak: Background on the Mental Health Impact of Natural Disasters, including Epidemics
"It is only relatively recently that attention has been focused on the mental health impact of disasters. Previously, concerns related to immediate physical health and community infrastructure risks in the aftermath of disasters such as storms, earthquakes, or floods had overwhelmed considerations of the short and long-term mental health consequences of disasters, or the extent to which mental health played a role in the impact of a disaster. In the arena of the health impact of natural disasters, the majority of data available relate to weather or geologic events. [...] We know that severe stress reactions are common; that front-line health and human services workers are at high risk for PTSD [Post Traumatic Stress Disorder]; and that in general, even in relatively developed countries, there is very little existing infrastructure in place that can adequately address the mental health needs of victims. In contrast, there is almost no data on the mental health impacts of outbreaks of disease. This is largely because there have been few pandemic health threats in the last century. Since the highly lethal pandemic outbreak of influenza in 1918, there have been few global threats from infectious agents. The recent outbreaks of SARS [Severe Acute Respiratory Syndrome] in Asia and Canada, which caused global concern but fortunately did not result in large-scale outbreaks nor a global pandemic, gives us the most recent data on the mental health concerns that are relevant in a pandemic outbreak situation."
Uniformed Services University of the Health Sciences. Center for the Study of Traumatic Stress
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Department of Defense Guidance for Preparation and Response to an Influenza Pandemic caused by the Bird Flu (Avian Influenza)
"The attached Department of Defense (DoD) Pandemic Influenza Preparation and Response Planning Guidance provides instructions on activities to undertake in order to prepare the DoD for the possibility of an influenza pandemic. This guidance implements the recommendations from the National Pandemic Influenza Response plan by the Department of Health and Human Services (HHS) and is tailored to the unique needs of the DoD. Epidemics of influenza occur annually around the world. In the northern hemisphere, they occur over the winter between October and March. Influenza pandemics occur infrequently and cause substantially higher morbidity and mortality. Whereas most annual epidemics impact the elderly and other medically high-risk groups, pandemics or uncontrolled global outbreaks cause significantly higher illness and death rates in generally healthy groups (such as young adults or military personnel) who are not usually affected by annual epidemics."
United States. Department of Defense
2004-09-21
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Potential Influenza Pandemic: An Update on Possible Macroeconomic Effects and Policy Issues
"In December 2005, at the request of the Senate Majority Leader, the Congressional Budget Office (CBO) prepared an assessment of the possible macroeconomic effects of an avian flu pandemic. In its assessment, CBO also described the nation's preparedness for a pandemic and options for increasing preparedness. At the request of the Majority Leader and the Chairman of the Senate Budget Committee, CBO has undertaken this update to its earlier work, focusing on changes in the budgetary and economic aspects of the nation's preparedness. Although a pandemic could be caused by any of several influenza strains, scientists are particularly worried about H5N1, a strain that has caused repeated epidemics with high mortality among poultry in Asia; has spread from Southeast Asia to flocks in Central Asia, Europe, and Africa; and has made the jump from birds to humans, causing the deaths of over 120 people. Infectious diseases are unpredictable, so it is impossible to say for sure whether a new pandemic will arise; whether it will involve the H5N1 virus; and, if it does, when it will happen and whether it will be mild or severe. The H5N1 virus could mutate in a way that causes a severe pandemic next year or a mild epidemic in a decade or two. Or it could evolve in a way that renders it harmless. Or a pandemic could arise from an entirely different virus subtype."
United States. Congressional Budget Office
2006-05-22
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Is the Fremont Fire Department Ready for a Pandemic?
"The problem is the City of Fremont is located in an area of the country that is widely diverse and highly populated. Consequently, the citizens of Fremont and surrounding communities are vulnerable to a rapid spread of a pandemic flu epidemic. The purpose of this research project was to identify if the City of Fremont is prepared and equipped to handle a pandemic outbreak and to compare Fremont's readiness model to recommendations of leading authorities. The descriptive research method was used to find out: a) What is the current capability of the Fremont Fire Department in handling a pandemic flu outbreak? b) What percentage of the community is at the highest risk in a pandemic epidemic? c) What are the recommendations of leading authorities on pandemic preparedness? and d) Is Fremont in compliance with recognized recommendations? Through literature review and personal interviews, it was discovered that a large percentage of the Fremont community is considered in the high risk category for contracting the 2009 H1N1 virus. Although Fremont's Metropolitan Medical Response System (MMRS) and Medical Reserve Core (MRC) are current programs in the Department, recommendations in this study encourage the development of a pandemic preparedness plan and suggest enhancement on current capabilities of operational readiness by improving training and communications with employees and the public. Recommendations also include preparedness planning and activities that should be developed in collaboration with the local County Health Department, hospitals and key stakeholders in the community."
National Fire Academy
Maize, Ronald
2010-02
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Potential Influenza Pandemic: Possible Macroeconomic Effects and Policy Issues
"There is widespread concern among policymakers and public health experts about the possibility of a worldwide epidemic of avian influenza. Such pandemics are not new: there were three in the 20th century, of which one, the 1918"1919 Spanish flu outbreak, is estimated to have killed over 500,000 people in the U.S. and up to 50 million worldwide. Public health concerns arise because of the challenge of creating the public health infrastructure in the United States and other countries that would be adequate to meet the challenges of a severe pandemic. Although a pandemic could be caused by any of several influenza strains, scientists are particularly worried about H5N1, a strain that has caused repeated epidemics with high mortality among poultry in Asia, has spread from Southeast Asia to flocks in Central Asia and Europe, and has made the jump from birds to humans, causing the deaths of over 60 people. Moreover, viruses of the H5 subtype are not known to have ever circulated among the human population, which means that there would be little immunity to it. To date, close contact with infected poultry is thought to be required for human infection, but the danger exists that the virus will evolve in a way that allows for efficient human-to-human transmission. If the virus does acquire that capability, a worldwide epidemic, or pandemic, could occur. Depending on the virulence of the particular strain of flu, such an outbreak could have substantial consequences for people and economic activity around the world."
United States. Congressional Budget Office
2005-12-05
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Influenza Pandemic: Challenges Remain in Preparedness, Statement of Marcia Crosse, Director, Health Care, Testimony before the Subcommittee on Health, Committee on Energy and Commerce, House of Representatives
"Vaccine shortages and distribution problems during the 2004-2005 influenza season raised concerns about the nations ability to respond to a worldwide influenza epidemic--or influenza pandemic--which many experts believe to be inevitable. Some experts believe that the next pandemic could be spawned by the recurring avian influenza in Asia. If avian influenza strains directly infect humans and acquire the ability to be readily transmitted between people, a pandemic could occur. Modeling studies suggest that its effect in the United States could be severe, with one estimate from the Centers for Disease Control and Prevention (CDC) ranging from 89,000 to 207,000 deaths and from 38 million to 89 million illnesses. GAO was asked to discuss surveillance systems in place to identify and monitor an influenza pandemic and concerns about preparedness for and response to an influenza pandemic. This testimony is based on GAO's 2004 report on disease surveillance; reports and testimony on influenza outbreaks, influenza vaccine supply, and pandemic planning that GAO has issued since October 2000; and work GAO has done in May 2005 to update key information."
United States. Government Accountability Office
2005-05-26
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Influenza Pandemic: Challenges in Preparedness and Response, Statement of Marcia Crosse Director, Health Care, Testimony Before the Committee on Government Reform, House of Representatives
"Shortages of influenza vaccine in the 2004"05 and previous influenza seasons and mounting concern about recent avian influenza activity in Asia have raised concern about the nation's preparedness to deal with a worldwide influenza epidemic, or influenza pandemic. Although the extent of such a pandemic cannot be predicted, according to the Centers for Disease Control and Prevention (CDC), an agency within the Department of Health and Human Services (HHS), it has been estimated that in the absence of any control measures such as vaccination or antiviral drugs, a 'medium-level' influenza pandemic could kill up to 207,000 people in the United States, affect from 15 to 35 percent of the U.S. population, and generate associated costs ranging from $71 billion to $167 billion in the United States. GAO was asked to discuss the challenges the nation faces in responding to the threat of an influenza pandemic, including the lessons learned from previous annual influenza seasons that can be applied to its preparedness and overall ability to respond to a pandemic. This testimony is based on GAO reports and testimony issued since 2000 on influenza vaccine supply, pandemic planning, emergency preparedness, and emerging infectious diseases and on current work examining the influenza vaccine shortage in the United States for the 2004"05 influenza season."
United States. Government Accountability Office
2005-06-30
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Flu View: 2008-2009 Influenza Season, Week 23 Ending June 13, 2009
"On June 11, the World Health Organization raised the pandemic alert level from Phase 5 to Phase 6 indicating that an influenza pandemic is underway. The novel influenza A (H1N1) virus now will be referred to as 'pandemic H1N1 influenza virus.' Synopsis: During week 23 (June 7-13, 2009), influenza activity decreased in the United States, however, there were still higher levels of influenza-like illness than is normal for this time of year. 1) Two thousand seven hundred sixty-five (38.7%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza. 2) Over 98% of all subtyped influenza A viruses being reported to CDC were pandemic influenza A (H1N1) viruses. 3) The proportion of deaths attributed to pneumonia and influenza (P&I) was slightly above the epidemic threshold. 4) One influenza-associated pediatric death was reported and was associated with pandemic influenza A (H1N1) virus infection. 5) The proportion of outpatient visits for influenza-like illness (ILI) was below the national baseline. One of the 10 surveillance regions reported ILI above their region-specific baseline. 6) Eleven states reported geographically widespread influenza activity, six states and Puerto Rico reported regional influenza activity, the District of Columbia and 13 states reported local influenza activity, and 20 states reported sporadic influenza activity."
Centers for Disease Control and Prevention (U.S.)
2009-06-13
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Influenza Pandemic: Efforts to Forestall Onset Are Under Way; Identifying Countries at Greatest Risk Entails Challenges, Report to Congressional Requesters
"Since 2003, a global epidemic of avian influenza has raised concern about the risk of an influenza pandemic among humans, which could cause millions of deaths. The United States and its international partners have begun implementing a strategy to forestall (prevent or delay) a pandemic and prepare to cope should one occur. Disease experts generally agree that the risk of a pandemic strain emerging from avian influenza in a given country varies with (1) environmental factors, such as disease presence and certain highrisk farming practices, and (2) preparedness factors, such as a country's capacity to control outbreaks. This report describes (1) U.S. and international efforts to assess pandemic risk by country and prioritize countries for assistance and (2) steps that the United States and international partners have taken to improve the ability to forestall a pandemic. To address these objectives, we interviewed officials and analyzed data from U.S. agencies, international organizations, and nongovernmental experts. The U.S. and international agencies whose efforts we describe reviewed a draft of this report. In general, they concurred with our findings. Several provided technical comments, which we incorporated as appropriate."
United States. Government Accountability Office
2007-06-20
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Pandemic Influenza Impact on Workforce and Critical Infrastructure
This document is a fact sheet regarding pandemic influenza impact analysis produced by the National Infrastructure Simulation and Analysis Center (NISAC) under the Department of Homeland Security. "Conclusions from the epidemiological and mitigation strategy analyses conducted to date include: response time is most important, other factors are secondary; partially effective response early is best; geospatial dynamics are important; face masks can reduce or prevent an epidemic; border control can only delay an epidemic and a 95% reduction in the contagious individuals entering the country delays the epidemic by 5 weeks; and social distancing is also effective in delaying an epidemic, but returning to normal interactions without other mitigation measures causes waves of outbreaks."
United States. Department of Homeland Security
2006
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Lessons Learned From School Crises and Emergencies: H1N1: Responding to an Outbreak in New York City Schools
In this issue of Lessons Learned from School Crises and Emergencies: "When the H1N1 virus was first identified in New York City schools during the late spring of 2009, the breadth and scope of this school system presented unique issues in the face of a pandemic threat. However, New York City's response to the virus, and experiences gained from the process, are transferable to other cities, schools and systems of all sizes. This document will highlight both the successes and lessons that the New York City public schools learned in responding to the H1N1 virus, and provide important instruction in pandemic planning and response for schools and communities across the nation. The H1N1 virus was first detected in New York City soon after a number of students from St. Francis Preparatory School in Queens returned from Mexico and exhibited flu-like symptoms. The size of the outbreak resulted in the activation of the Citywide Incident Management System (CIMS), which utilizes an Incident Command Structure.1 For public health emergencies, such as pandemics, the New York City Department of Health and Mental Hygiene (DOHMH) is the lead city agency, and so it launched a coordinated response according to the DOHMH's Pandemic Influenza Preparedness and Response Plan. DOHMH considered school closure as one measure to reduce the impact of the H1N1 epidemic and developed standards for recommending school closure."
Readiness and Emergency Management for Schools Technical Assistance Center (U.S.)
2009
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Role of the Department of Defense During A Flu Pandemic [June 4, 2009]
"A flu pandemic is a worldwide epidemic of an influenza virus. As such, the United States' response to a flu pandemic would have both international and domestic components. Additionally, the domestic response effort would include contributions from every governmental level (local, state, tribal, and federal), non-governmental organizations, and the private sector. This report will focus largely on the role of the Department of Defense (DOD) in supporting the nation's domestic response effort, although it will also touch on DOD's international role. The Department of State would lead the federal government's international response efforts, while the Department of Homeland Security and the Department of Health and Human Services would lead the federal government's domestic response. The Department of Defense would likely be called upon to support both the international and domestic efforts. An analysis of the tasks assigned by the National Strategy for Pandemic Influenza Implementation Plan indicates that DOD's role during a flu pandemic would center on the following objectives: assisting in disease surveillance; assisting partner nations, particularly through military-to-military assistance; protecting and treating US forces and dependents; and providing support to civil authorities in the United States."
Library of Congress. Congressional Research Service
Kapp, Lawrence; Jansen, Don J.
2009-06-04
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History of Biological Warfare
This document provides a brief history of biological warfare from 1346 to 1992. The use of bacteriological agents in an armed conflict can be dated back to 1346, at Kaffa (now Feodossia) where the bodies of Tartar soldiers who succumbed to the plague were thrown over the walls of the besieged city. It is hypothesized by some medical historians that the action resulted in the infamous pandemic that spread over the entire continent of Europe from Genoa, via the Mediterranean ports. 1710 During the war between Russia and Sweden, Russian troops are said to have used the cadavers of plague victims to provoke an epidemic with the enemy. 1767 The French and Indian War was fought in North America between France and England during the period of 1754- 1767. Both sides relied heavily on the support of Indian allies. The English attacked Ft. Carillon twice and were repulsed with heavy losses. An English general, Sir Jeffery Amherst, surreptitiously provided the Indians loyal to the French with blankets infected with smallpox virus. The resulting epidemic decimated the Indians. Shortly thereafter, General Amherst successfully attacked Ft. Carlillon and renamed it Ft. Ticonderoga. By deduction, the small pox epidemic played a significant role in the victory. The timeline continues with World War I through 1991.
United States. Department of Defense
2001
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2018 Progress Report: PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020)
"The American people's compassion and generosity have saved more than 16 million lives and brought us closer than ever to controlling the HIV/AIDS pandemic - community by community, country by country. Fifteen years ago when the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) was launched this remarkable progress was hard to imagine. [...] The United States is the world's leader - and largest donor - in the response to the global HIV/AIDS crisis. Since PEPFAR's establishment in 2003, with strong bipartisan support across three U.S. presidents (George W. Bush, Barack Obama, and Donald J. Trump) and from eight U.S. congresses, the U.S. government, through PEPFAR, has invested more than $80 billion in the global HIV/AIDS response, the largest commitment made by any nation to address a single disease. By focusing resources where the HIV burden was the greatest and the most impact could be achieved, PEPFAR has delivered remarkable results in just 15 years. [...] In September 2017, the Trump Administration launched the PEPFAR Strategy for Accelerating HIV/ AIDS Epidemic Control (2017-2020). The PEPFAR Strategy is focused on ensuring that every dollar we invest is maximizing impact and hastening progress toward achieving HIV/AIDS epidemic control. This 2018 PEPFAR Strategy Progress Report shows the significant strides we have taken in the first year of the Strategy's implementation. With the U.S. government's support, and through our collaboration with many partners, several African countries are on pace to control their HIV/AIDS epidemic by 2020."
United States. Department of State
2018-09
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Halting Global Pandemics via the Commercial Air Route Network
"How can a pandemic like SARS [Sudden Accute Respiratory Syndrome] be halted in the modern age of air travel? This article argues that the classical mathematical models of epidemics are inadequate for describing the impact of air travel on the spread of contagions like SARS. Instead, the author proposes a modern model that incorporates air travel as the main vehicle or vector of disease spreading. The new model is based on network science instead of the traditional Kermack-McKendrick model and its many derivatives. The new model uses spectral radius ρ and blocking node analysis in place of basic reproduction number R0 as metrics for stopping pandemics. This article compares three strategies for defeating pandemic spreading: 1) quick and effective removal by quarantine or inoculation of (n/R0) people from a population of size n; 2) removal by quarantine or hardening of airports at the rate of ∆ > γρ; and 3) blocking by quarantine or hardening of approximately n/ρ blocking nodes in the air route network. The third strategy is illustrated for the airports and air routes in the OpenFlight commercial air route network. Symbols: n: population size in terms of people or airports; R0: basic reproduction number; ∆: removal rate; γ: infectiousness; and ρ: spectral radius."
Naval Postgraduate School (U.S.). Center for Homeland Defense and Security
Lewis, T. G. (Theodore Gyle), 1941-
2016-02
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Report to the President on U.S. Preparations for 2009-H1N1 Influenza
"In April 2009, a novel influenza A (H1N1) virus (2009-H1N1) appeared in Mexico, causing pneumonias and 59 deaths in Mexico City alone. The virus soon spread to the United States and to other continents. Within two months, the World Health organization (WHO) declared that the viral outbreak met the criteria of a level 6 pandemic. Although initial concerns of an extremely high fatality rate have receded, the expected resurgence of 2009-H1N1 in the Fall poses a serious health threat to the United States. Since the initial report of the outbreak, the Federal Government, through various departments, agencies, and offices, has been actively studying the course of events, responding to them, and planning for a resurgence of the pandemic this fall. In late June, President Obama requested that his Council of Advisors on Science and Technology (PCAST) undertake an evaluation of the 2009-H1N1 epidemic and the nation's response to a probable recurrence. In this Executive Report, PCAST assesses the emerging Federal response to a second wave, identifies critical questions and gaps in this response, and suggests additional opportunities for mitigation. PCAST's observations, conclusions, and recommendations presented here are based on the analysis of its 2009-H1N1 Working Group, consisting of 3 PCAST members and a further 11 non-governmental experts in virology, public health, pediatrics, medicine, epidemiology, immunology, and other relevant scientific fields. The Working Group's deliberations were informed by discussions with government officials and others on various aspects of the 2009-H1N1 pandemic."
President's Council of Advisors on Science and Technology (U.S.)
2009-08-07
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Pandemic Flu: For Servicemembers and their Families
"Pandemic flu is a global outbreak of flu that occurs when a new flu virus appears in people, causes serious illness, and spreads easily from person to person. A pandemic is a global outbreak of disease, while an epidemic is a widespread or regional outbreak. During the 20th Century, new influenza viruses caused three pandemics, the most recent in 1968. The most severe was the 1918-1919 'Spanish Flu', which caused more than 500,000 deaths in the United States and 20-40 million deaths worldwide. Nearly half of those who died were young, healthy adults. The first documented human cases of H5N1 avian flu were found in 1997 when six people were infected and died in Hong Kong during a large outbreak of influenza among poultry. Beginning in late 2003, outbreaks among poultry were reported throughout Southeast Asia with extension into Central Asia, Russia, and Eastern Europe. Scattered human cases of H5N1 avian flu have occurred among people who had direct contact with sick poultry or who ate undercooked poultry infected with the virus. So far, spread of H5N1 avian flu virus has been rare and has not continued beyond one person."
United States. Department of Defense; United States. Air Force Institute for Operational Health
2005-12-07
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Serial No. 109-61: Protecting the Homeland: Fighting Pandemic Flu from the Front Lines: Joint Hearing before the Subcommittee on Prevention of Nuclear and Biological Attack Joint With the Subcommittee on Emergency Preparedness, Science, and Technology of the Committee on Homeland Security, House of Representatives, One Hundred Ninth Congress, Second Session, February 8, 2006
"The subcommittees are meeting today to hear testimony on protecting the homeland in fighting pandemic flu on the frontlines. I would like to welcome and thank our distinguished panel of witnesses for appearing today before this joint hearing of these two subcommittees. Imagine this scenario. On September 29, seven deaths were reported in Washington. By October 2, there had been a total of 35. By the middle of October, 60 to 90 people were dying each day. By then, the city's commissioners had taken drastic steps, first closing the schools, then prohibiting any large indoor public gatherings, including church services. The Red Cross nurses were caring for the sick, who were flooding area hospitals, or worse, suffering unattended in their homes. Disposal of bodies became a particular problem. On October 12, the U.S. Capitol shut its door to visitors. Ladies and gentlemen, this is an account of life in the fall of 1918 here in Washington, D.C., reported in The Washington Post. The United States, like most of the rest of the world, was gripped with a pandemic of Spanish influenza. With over 50 million deaths worldwide, it was the third-largest epidemic in recorded history, and the largest since the Middle Ages. Today, the possibility exists that the world may face yet another deadly outbreak, this time from an avian influenza strain known as H5N1. While the virus has not yet evolved into a form easily transmissible between humans, should it acquire that capability, it is similar to the 1918 pandemic."
United States. Government Printing Office
2007
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Swine Flu Episode and the Fog of Epidemics
"The 1918 influenza pandemic has shaped research and public health for nearly a century. In 1976, the specter of 1918 loomed large when a pandemic threatened the country again. Public health officials initiated a mass vaccination campaign, but the anticipated pandemic failed to occur. An examination of the available data in 1976 and the decision to vaccinate, as well as lessons learned from the HIV/AIDS epidemic in the early 1980s, may help shape an appropriate public health response to future threats from avian influenza or other infectious diseases"
Emerging Infectious Diseases
Krause, Richard M.,1925-2015
2006-01
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Pandemic Influenza and Excess Intensive-Care Workload
This article provides estimates for peak demand for healthcare workers during an epidemic or pandemic, factoring in healthcare worker absenteeism and using estimates from published epidemiologic models on the expected evolution of pandemic influenza in relation to the impact on peak surge capacity of healthcare facilities and intensive care units. The article shows that even during the peak of a pandemic, all patients requiring hospital and ICU admission can be served, including those who have non-influenza-related conditions. Please Note: This record has been imported to the HSDL as part of the LLIS Consolidation project and has not yet been reviewed by HSDL staff. Some information may be incomplete, missing, or inaccurate. For more information on the LLIS Consolidation project, please see here: [http://www.hsdl.org/?llis]
Centers for Disease Control and Prevention (U.S.)
Nap, Raoul E.; Andriessen, Maarten P.H.M.; Meessen, Nico E.L. . . .
2008-10
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Cooperative Crisis Management and Avian Influenza: A Risk Assessment Guide for International Contagious Disease Prevention and Risk Mitigation
"This paper proposes a risk assessment and mitigation strategy designed to give both national authorities and international organizations the diagnostic tool needed to evaluate preparedness, identify country-level weaknesses, and prioritize scarce resources to combat avian influenza. This tool could help authorities and agencies at all levels of government identify risk factors and actions that may be taken to reduce vulnerabilities to communicable disease outbreaks; prevent animal-to-human disease transmission; improve the response to a communicable disease outbreak; and empower government authorities to communicate with local, national, and international partners. Without adequate prevention efforts, a communicable disease outbreak can rapidly spread and develop into an epidemic. Without an adequate response plan, an epidemic is more likely to become a pandemic. The prevention and response phases of crisis management are aimed at the most important element of cooperative crisis management: preventing loss of life. Senior decision makers who must make crisis management choices in the face of limited information often need practical experience to support this process. The risk assessment and mitigation strategy becomes an essential tool to which these decision makers may turn in a crisis."
National Defense University. Center for Technology and National Security Policy
Thompson, Donald F., Dr.
2006-03
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Serial No. 109-21: The Threat of and Planning for Pandemic Flu: Hearing before the Subcommittee on Health of the Committee on Energy and Commerce, House of Representatives, One Hundred Ninth Congress, May 26, 2005
From the opening statement of Nathan Deal: "All of us, I think, can attest to the fact that the fear of a global influenza epidemic or a flu pandemic is certainly one of the greater health challenges and threats that our country faces and our world faces. All of us have different perspectives on this. I have heard people, as we have talked about having a hearing like this, saying that they remembered the Asian Flu, they remembered the flu epidemics when they were in college, and all of these things… You might ask why the linkage with the veterinary testimony. Part of it is the fact that my hometown calls itself the poultry capital of the world, and we have for many, many years, of course, been concerned with Avian Flu and the effects on the poultry industry here and across the world. But there is a direct linkage, as you will hear, in the threat and trying to eliminate the threat within the poultry and fowl of the world so that there is no transmission. So there is a linkage and we certainly want to hear about that today." Statements, letters, and materials submitted for the record include those of the following: Nathan Deal, Marcia Crosse, Anthony S. Fauci, Bruce G. Gellin, Julie L. Gerberding, Phillip Hosbach, Dominick A. Iacuzio, Andrew T. Pavia, and Ralph A. Tripp.
United States. Government Printing Office
2005
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Legal Responses to Health Emergencies
"This report contains discussions of the regulations addressing health emergencies in twenty-five jurisdictions. The jurisdictional surveys that are included cover countries from six continents and reflect national, regional (European Union, EU), and international (World Health Organization, WHO) approaches to the problem. The report is supplemented by an annotated bibliography that lists recently published English-language monographs and academic articles on issues related to handling public health crises. All surveys included in this report review government structures tasked with delivering public health protection, relevant legislative frameworks for addressing health emergencies, and the powers of government institutions in times of health crises and their ability to mitigate the consequences of such crises. Analyses of the regulation of such issues as disease surveillance and notification systems are also provided. Individual surveys discuss the role of medical and emergency services personnel in responding to public health challenges, the coordination of government activities aimed at minimizing the spread of epidemics, and the cooperation of national health-care institutions with the WHO in implementing pandemic preparedness measures. Measures taken by national governments in response to recent outbreaks of infectious diseases, including the Ebola epidemic in western Africa in 2014, are also described."
Law Library of Congress (U.S.)
2015-02
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Preparing the Justice System for a Pandemic Influenza and Other Public Health Emergencies: An Initiative of the Bureau of Justice Assistance
"The Bureau of Justice Assistance (BJA) recognizes that public health emergencies, whether an epidemic or pandemic influenza, biological terrorist attack, or natural disaster with public health implications can threaten America's justice system and place the rule of law at risk. BJA has undertaken a broad-scope initiative to identify the critical planning and response objectives for local justice systems and to identify lessons learned and promising approaches in preparing the justice system for such emergencies. The goal of BJA's initiative is to ensure that the rule of law is upheld during any public health crisis, whether natural or manmade. This initiative's design parallels the major components of the justice system: law enforcement, courts, corrections, and communities. BJA's pandemic initiative is coordinated through a consortium that includes representatives from each project and component of the system and meets regularly to discuss findings and issues."
United States. Bureau of Justice Assistance
2006-01
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Remarks on the National Strategy for Pandemic Influenza Preparedness and Response in Bethesda, Maryland, November 1, 2005
This document presents the text of a speech given by President George W. Bush in Bethesda, Maryland on November 1, 2005. In this speech the President discusses the pandemic influenza and offers commentary on the need for the United States to continue taking the offensive in the fighting this epidemic. Finally, President Bush describes what actions the United States has taken combat the spread of pandemic influenza.
United States. Government Printing Office
2005-11-07
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FDA Medical Countermeasures Initiative (MCMi): Fiscal Year 2014 Program Update
"I am pleased to present the FDA Medical Countermeasures Initiative (MCMi) program update for our fourth year of operations.a In addition to our ongoing work to advance the development and availability of medical countermeasures to protect against chemical, biological, radiological, and nuclear (CBRN) threats, we have also responded to emerging public health threats in an unprecedented way. The Ebola epidemic in West Africa tested systems we've been putting in place since MCMi was launched in 2010, including new legal authorities granted by the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA); numerous collaborations with industry, academia, government and international partners; and our investments in regulatory science research--research required to facilitate the development of medical countermeasures and inform their use in emergency situations.International cooperation is critical to address key public health challenges. In FY 2014, in collaboration with numerous partners, we made progress on key global and public health issues, including antimicrobial resistance and pandemic influenza, approving the first adjuvanted vaccine for the prevention of H5N1 influenza."
United States. Food and Drug Administration
2014
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State Plans for Containment of Pandemic Influenza
This review assesses differences and similarities of, the states in planning for pandemic influenza. It reviews, posted plans of 49 states for vaccination, early, epidemic surveillance and detection, and intraepidemic, plans for containment of pandemic influenza. LLIS Core Capability: Public Health; State and Local Executive Offices; Community Preparedness
Centers for Disease Control and Prevention (U.S.)
Holmberg, Scott D., 1950-; Layton, Christine M.; Ghneim, George S. . . .
2006-09
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Serial No. 115-136: Examining the Reauthorization of the Pandemic and All-Hazards Preparedness Act, Hearing Before the Subcommittee on Health of the Committee on Energy and Commerce, House of Representatives, One Hundred Fifteenth Congress, Second Session, June 6, 2018
This is the June 6, 2018 hearing on "Examining the Reauthorization of the Pandemic and All-Hazards Preparedness Act," held before the Subcommittee on Health of the Committee on Energy and Commerce. From the opening statement of Hon. Gene Green: "Events in recent years including natural disasters, cyber terrorism, influenza epidemic has posed a threat to our public health systems and our national security. PAHPA [Pandemic and All Hazards Preparedness Act] provides a framework that allows us to address in a coordinated way various threats both natural and manmade. [...] I hope our committee will look at the very real threat that antimicrobial resistance poses. Antibiotics and antimicrobial agents have been used for the last 70 years to treat patients who have infectious diseases. These drugs greatly reduce illnesses and death from infectious diseases. However, these drugs are being used so widely and for so long that the infectious organisms that the antibiotics are designed to kill have adapted to them and make the drugs less effective. [...] Through the reauthorization of PAHPA we need to ensure that the proper incentives are in place that will lead to investment in the development of new antibiotics and antimicrobial agents." Statements, letters, and materials submitted for the record include those of the following: Robert Kadlec, Stephen Redd, Anna Abram, Umair Shah, Michelle Berrey, and Erik Decker.
United States. Government Publishing Office
2019
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Lessons Learned from a Full-Scale Bioterrorism Exercise
"During May 20-23, 2000, local, state, and federal officials, and the staff of three hospitals in metropolitan Denver, participated in a bioterrorism exercise called Operation Topoff. As a simulated bioterrorist attack unfolded, participants learned that a Yersinia pestis aerosol had been covertly released 3 days earlier at the city's center for the performing arts, leading to >2,000 cases of pneumonic plague, many deaths, and hundreds of secondary cases. The exercise provided an opportunity to practice working with an infectious agent and to address issues related to antimicrobial prophylaxis and infection control that would also be applicable to smallpox or pandemic influenza. In Colorado, where plague is endemic, we are familiar with the public health management of single plague cases, but the magnitude of the simulated epidemic and the fact that infection was spreading from person to person after a short (2- to 3-day) incubation period quickly overwhelmed the available resources. The challenge to our surveillance system was not in detecting the outbreak but rather in maintaining surveillance at each of the 22 acute-care hospitals in metropolitan Denver. Our hospital surveillance system usually relies on reporting by infection control practitioners, but during the exercise these practitioners had many additional responsibilities. In a true bioterrorist attack, emergency response teams of state or local health department employees should be set up and sent to each hospital to monitor cases and provide information to a central command center."
Centers for Disease Control and Prevention (U.S.)
Hoffman, Richard E.; Norton, Jane E.
2000
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Role of Environment in One Health security and National Health Security
"Across the world, ministries of environment and natural resources and/or environmental protection agencies have different mandates and missions, but many of them focus on the protection of the environment with the goal of protecting public health. Environmental health practitioners monitor food safety from farm to table: are responsible for vector and vermin monitoring and control; and monitor microbial and chemical pollution of the land, water, and air. Natural resource mangers monitor ecosystems and landscapes and the creatures that occupy them. They often see trends in the natural world before they are seen in the urban world. For example, unusual wildlife morbidity and mortality can indicate presence of pathogenic or toxic agents that could potentially be detrimental to human health. The environment sector is a valuable contributor in the promotion of population health and well-being, particularly in 'health security' efforts to prevent and prepare for endemic, epidemic, and pandemic threats."
United States. Agency for International Development
