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A workshop on Public Health Safety and Emergency Response Preparedness and Response

A workshop on Public Health Safety and Emergency Response Preparedness and Response To Bioterrorism in Korea 韩国对生物恐怖的应对 17-18 May 2006, Beijing. Division of Preparedness and Response to Bioterrorism 韩国 CDC 生物恐怖应对部 KCDC/MOHW. Background 背景.

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A workshop on Public Health Safety and Emergency Response Preparedness and Response

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  1. A workshop on Public Health Safety and Emergency Response Preparedness and Response To Bioterrorism in Korea 韩国对生物恐怖的应对 17-18 May 2006, Beijing Division of Preparedness and Response to Bioterrorism 韩国CDC生物恐怖应对部 KCDC/MOHW

  2. Background 背景 • Anthrax letter outbreak since 11th September 2001 2001年9月11日炭疽信事件 • Establishment of Strategy on bioterror in Nov 2001 2001年11月生物反恐策略建立 • Establishment•Operation of system on duty at emergency 建立和实施突发事件工作制度 • Stockpiling of antibiotics, vaccine, equipment and facilities 抗生素、疫苗、设备和器械储备 • Dual-Use surveillance system for early detection 可两用的早期识别监测系统 • Laboratory Diagnosis System 实验室诊断系统 • Reinforcement of Education•Training 加强教育培训

  3. Capacity Building 能力建设 Surveillance System 监测系统 National Bioterrorism preparedness and response 国家级生物反恐应对 LaboratoryDiagnosis System 实验室诊断系统 Stockpile 物资储备 Preparedness & Response to Bioterrorism in Korea韩国生物恐怖的应对

  4. Capacity Building能力建设 • Strengthening of organization and Professional manpower 机构和专业人员 • Construction of Counter terror Intelligence Integration Center 反恐智能联合中心的建设 • Construction of Division of Preparedness and Response to Bioterrorism, KCDC in Dec. 2003 韩国CDC生物反恐应对处的建立（2003.12） • Construction•Operation of Bioterrorism Task Force Team in MOHW, KCDC, Province(16), Public Health Center(248) 韩国卫生部/CDC生物反恐工作组建立并开展行动。16个省、248个公共卫生中心

  5. President 总统 Nat’l Counter-terror HQ 国家反恐总部(Prime Minister总理) Counter-terror Intelligence Integration Center 反恐智能联合中心 CTC : Conciliation. Support安抚 MOFAT : Foreign affairs外交 MOL : Immigration移民 MOD : support支持 MOC : Airport机场 MOA&F : Agriculture, animal农业，动物 MOE : Drinking water饮水 MOM : Port港口 FDA ; Food & drug食品和药品 DDA : response应对 LA : investigation调查 PA : On spot response现场处理 Relative Ministries相关部委 Bio-terror HQ 生物反恐总部 ( Vice Min. of MOHW 卫生部副部长) Task Force Team 工作组 Control of national status Emergency support 国家紧急状态控制 Control Center on Spot 现场指挥中心 (Director of Dept. of Infectious Disease Control, KCDC CDC传染病控制处处长 Counter-terror Provincial Council 省级反恐委员会 Support Team支持性工作队 Case Control Team 病例研究组 Investigation Team调查队 Provincial office, Fire, Disaster Adm. KCDC省办公室，救火、灾难管理 Fire, Envir. Elect., Comm. Tap., Const. 救火、环境、电力、交通、自来水、建设等、 (If neces. support) Investigation调查 NIS, PA LA, DOD Epidemic Investigation KCDC, Provincial Office 流行调查，CDC省办公室 First Response Team急救队(Chief: Director of police队长：警察局长) police, fire, health etc.警察、灭火、卫生等 National Bioterror Headquarter 国家反恐总部

  6. Bioterrorism TFT in Ministry of Health and Welfare 卫生部反恐工作组 Bioterrorism TFT 反恐工作组 (Vice-Minister of MOHW 副部长) General Inspection Support Team检查组 Medical service, food, Support Team 医疗服务、食品、支持组 Public Health Team 公共卫生组 Life Security Support Team生活保障组

  7. Bioterrorism Task Force Team 反恐工作组 MicroorganismDetection Team 微生物检测组 Countermeasure Team 提供对策组 Epidemiological Investigation Team 流行病学调查组 Surveillance Team 监测组 Bioterrorism TFT in KCDC CDC反恐工作组

  8. Bioterrorism TFT(MOHW) 反恐工作组（卫生部） Anti-Bioterrorism Task-Force Team(KCDC) 反恐工作组（CDC） Anti-Bioterrorism Task-Force Team(Province)反恐工作组（省级） MicroorganismDetection Team 微生物检测组 Countermeasure Team 提供对策组 EpidemiologicalInvestigation Team 流调组 Surveillance Team监测组 Anti-Bioterrorism Task-Force Team(District, Public Health Center)反恐工作组（区公卫中心） EpidemiologicalInvestigation Team流调组 CountermeasureTeam提供对策组 SurveillanceTeam监测组 Microorganism Detection Team微生物检测组 Bioterrorism TFT in Province•District 省-区级反恐工作组

  9. First Response Team (Chief : Director of police) 紧急应对组 （组长：警察局长） Police警察 Fire灭火 Public Health公共卫生 ※ Army support if necessary 必要时，军队支援 First Response Team紧急应对组

  10. Role of First Responders紧急反应队队员的职责 • Police警察 • Guard general population • 保卫整体人群 • Investigation and Searching out a criminal • 调查和搜寻罪犯 • Fire灭火 • Transfer Patients and specimen • 转移病人和样品 • Disinfection of Environment • 环境消毒 • Public Health公共卫生 • Management of patients•exposures • 病人和接触管理 • Examination by rapid detection test kit • 用快速检测试剂检验

  11. Capacity Building能力建设 • Amendment of law related to bioterrorism反恐相关法律的修改 • Definition of Bioterrorism 生物恐怖的定义 • Communicable diseases by Bio-terrrorism can be described as communicable diseases outbreaks by the use of a microorganism with the deliberated intention to being caused a infection in order to achieve certain goals 生物恐怖传染性疾病是为达到某种目的，恶意使用微生物，从而引起的感染导致的传染性疾病 • Major Communicable Diseases by Bioterrorism : report immediately 主要的生物恐怖传染病：立即报告 – Disease under Control Law : 5 classes 63 diseases疾病控制法要求报告的疾病：5类63种疾病 – Plague(Class 1), Anthrax(Class 3), Smallpox, Botulism, VHF(Class 4)鼠疫（1级），炭疽（3级），天花、波特淋菌中毒、VHF（4级） • Examination, conservation and control on Communicable Disease Pathogen 传染病病原体的检验、保存和控制 – Hospital, Quarantine station, KFDA, Nat’l Institute of Animal Science Quarantine, Nat’l Plant Quarantine station医院、接种站、KFDA、动物免疫研究所、植物免疫站 – Reports of name pathogen, isolated sample and isolated dates已知病原的报告、分离的样本和分离日期 • Establishing of BWC Implementation law BWC实施法的制定

  12. Capacity Building能力建设 • Study and research on bioterror 对生物恐怖的研究 • Development for practical use 使用方法的制定 • Vaccine and antitoxin 疫苗和抗病毒药 • New diagnosis method 新的诊断方法 • Multiple rapid detection test kit 多价的快速检测试剂 • Study on Policy Development 政策研究 • Scenario for response to bioterrorism 生物恐怖应对的游戏规则 • Effective operation method of surveillance system 监测系统有效的实施方法

  13. Capacity Building能力建设 • Training & Education教育培训 • Education for First Responders(Police, Fire, Public Health)紧急反应队伍的教育 • Training course in KCDC CDC培训班 • Education Program for the first responders at province level 省级紧急反应队员教育项目 • Development & Dissemination of Educational materials 教育教材制定和发放 • Education for reporters of Emergency Syndromic Surveillance System 突发事件症状监测系统报告员教育 • Exercise for response to bioterrorism反恐演练 – Anthrax Exercise(‘Silent Storm’) March 25, 2005 2005年3月25日炭疽演练（沉默的风暴）

  14. Capacity Building能力建设 • Establishment of website建立网络 • Public health centers : daily report of Bioterror suspicious case 公共卫生中心：生物恐怖可疑案件的日报 • Hospitals 医院 - Emergency dept : daily report based on syndromic surveillance 急诊室：症状监测基础上的日报 - Infectious medicine dept : when suspicious outbreak occur 传染病室：可疑暴发出现时 • Provide first responders and general population with bioterror information and news 向紧急反应队员和整体人群提供生物恐怖的信息和消息

  15. Capacity Building能力建设

  16. Capacity Building能力建设 • International Cooperation and Collaboration国际合作 • International Conference on bioterrorism preparedness and response in 2004, 2005 2004和2005年反生物恐怖国际研讨会 • Collaboration with WHO, USA(CDC), JAPAN(NIID) 与WHO、美国CDC、日本NIID合作 • Participation in WHO, APEC CTTF, SEARCCT, BWC meeting 参加WHO、APEC CTTF、SEARCCT、BWC会议

  17. Capacity Building 能力建设 Surveillance System 监测系统 National Bioterrorism preparedness and response 国家级生物恐怖应对 LaboratoryDiagnosis System 实验室诊断系统 Stockpile 物资储备 Preparedness & Response to Bioterrorism in Korea韩国生物恐怖应对

  18. Surveillance System监测系统 • Dual-Use Surveillance System 可以两用的监测系统 • Emergency Syndromic Surveillance System 突发事件症状监测系统 • Enhanced Emergency Surveillance System during special events 在特殊活动期间加强了突发事件监测系统 • Infectious Disease Specialist Network 传染病专报网

  19. Emergency Syndromic Surveillance System 突发事件症状监测系统 • Definition定义 to monitor unusual disease clusters based on sets of pre-diagnosis clinical signs, symptoms, or conditions that collectively may be indicative of a specific disease 以与某种疾病相关的、确诊前的临床表现、症状发作提示为基础，监测异常的疾病集聚性

  20. Emergency Syndromic Surveillance System 突发事件症状监测系统 • Objectives目的 • By closely monitoring the syndrome that are suspected of bioterrorism, possible disease spread due to bioterrorists‘ attacks can be prevented 紧密监测可疑的生物恐怖症状，紧密监测那些可以防止的生物恐怖进攻带来的疾病的传播 • The prevalence of water and food borne diarrhea diseases, and respiratory infectious diseases like influenza is promptly recognized for the quick response. 快速鉴别、快速应答水源性和食源性疾病、呼吸道感染，如流感的传播 • Reporting : web based http://bioterrorism.cdc.go.kr 网络报告 • Organization : 125 hospitals (Emergency Dept.) 机构：125家医院（急诊室） • Experts Committee : have meeting every semester 专家委员会：每学期开会

  21. Emergency Syndromic Surveillance Systemhttp://bioterrorism.cdc.go.kr突发事件症状监测系统

  22. The reportable diseases and patient要求报告的疾病和病人

  23. Reporting system报告系统

  24. Reported Cases of Emergency Syndromic Surveillance(’02-’05)02-05年突发事件症状监测系统报告的病例 unit : case单位：例

  25. Surveillance System监测系统 • Dual-Use Surveillance System 两用的监测系统 • Emergency Syndromic Surveillance System 突发事件症状监测系统 • Enhanced Emergency Surveillance System during special events 特殊活动期间强化了监测系统 • Infectious Disease Specialist Network 传染病专报网

  26. Enhanced Emergency Syndromic Surveillance System 强化的突发事件症状监测系统 • Definition定义 Enhanced Syndromic Surveillance System is operated through related area during special events such as ADB meeting, APEC meeting etc. 强化的突发事件症状监测系统在特殊活动期间，如ADB会议、 APEC会议等，在相关区域运行 • Purpose目的 Early detection and response to suspicious outbreaks in the related area during special events 在特殊活动期间对在相关区域可疑暴发的早期识别和应对

  27. Enhanced Emergency Syndromic Surveillance System强化的突发事件症状监测系统 • Expansion of Reportable organizataion 增加了报告机构 To add emergency departments in events area 增加了活动区域的急诊室 • Expansion of Reportable syndrome 增加了报告症状acute gastro-intestinal syndrome, acute respiratory syndrome, acute pneumonia, acute skin-rash syndrome, acute fever syndrome, septic/non-traumatic shock 急性肠胃炎、急性呼吸道、急性肺炎、急性皮疹、急性高热、脓血/非创伤性休克

  28. Operation of EESS 强化的突发事件症状监测系统的运行 • ’03 Daegu Universiade • ’04 Jeju ADB Meeting • ’05 APEC in Jeju – 6 May ~ 14 June 2005 • ’05 APEC in Kyeong Ju – 22Aug~28Sep2005 • ’05 APEC in Busan – 28 Oct ~ 4 Dec 2005

  29. Surveillance System监测系统 • Dual-Use Surveillance System 两用的监测系统 • Emergency Syndromic Surveillance System 突发事件症状监测系统 • Enhanced Emergency Surveillance System during special events 特殊活动期间强化了监测系统 • Infectious Disease Specialist Network 传染病专报网

  30. Infectious Disease Specialist Network 传染病专报网 • Definition定义 • provide healthcare professionals with information when a bioterrorists activities or emerging and re-emerging diseases are suspected in order to prevent epidemics 当出现生物恐怖活动或新发和再发疾病被怀疑与生物恐怖有关时，向卫生保健人员提供信息，防止出现流行 • provide information, news, materials, and overseas status about infectious disease 提供信息、消息、资料和传染病的国外状况

  31. Infectious Disease Specialist Network传染病专报网 • Reporting organization 报告机构 50 hospitals which have Department of infectious medicine and infectious pediatric 50家有传染病科和儿童传染病科的医院 • Reportable patients 报告病人 • Patients suspected of bioterror 生物恐怖疑似病人 - anthrax, smallpox, botulism, plague, viral hemorrhagic fever(VHF) 炭疽、天花、波特淋菌中毒、鼠疫、病毒性出血热（VHF） • Patients suspected of Diarrhea (mass) 腹泻疑似病人 • Advisory committee : 13 Experts consult about a reported case 顾问委员会：每个报告病例经13名专家研究

  32. Reporting System报告系统

  33. Infectious Disease Specialist Networkhttp://bioterrorism.cdc.go.kr传染病专门报告网

  34. Reported cases of Infectious Disease Specialist Network(’02-’05)02-05年传染病专报网报告的病例 unit : person单位：人 단위 : 건

  35. Capacity Building 能力建设 Surveillance System 监测系统 National Bioterrorism preparedness and response 国家级生物恐怖应对 LaboratoryDiagnosis System 实验室诊断系统 Stockpiling 物资储备 Preparedness & Response to Bioterrorism in Korea韩国生物恐怖应对

  36. Purpose目的 • Promote the readiness of national public health center labs and hospital labs for a swift diagnostic system 提高国家公共卫生中心实验室和医院实验室快速诊断系统的应急能力 • Construct laboratory network 创建实验室网络 • Share information among related laboratory experts 与各实验室专家分享信息

  37. National Institute of Health国家卫生研究所 Level C C级 Province Laboratory省级实验室 Level B1, B2 BI，B2级 Public health centers /National quarantine office公卫中心/国家免疫办公室 Level A A级 Hospital labs医院实验室 specimen transfer样品传递 share Information & education 信息共享 Laboratory System实验室系统

  38. Capacity Building 能力建设 Surveillance System 监测系统 National Bioterrorism preparedness and response 国家级生物恐怖应对 LaboratoryDiagnosis System 实验室诊断系统 Stockpiling 物资储备 Preparedness & Response to Bioterrorism in Korea韩国生物恐怖应对

  39. Stockpile物资储备 • Antibiotics and Vaccine 抗生素和疫苗 • Equipments 设备 • Facilities 设施和器械 • Rapid Detection Test Kit 快速诊断试剂盒

  40. Antibiotics and vaccine抗生素和疫苗 • Ciprofloxacine • Doxycycline • Smallpox vaccine and bifurcated needle

  41. Equipments设备 • Level A Personal Protective Equipment A级的个人防护设备 • Level C Personal Protective Equipment C级的个人防护设备 • Decon shower 消毒浴液 • Pressure Test Kit 压力试剂盒 • Fit Test Kit 便携试剂盒

  42. Facilities设施和器械 Laboratory in KCDC CDC实验室 Mobile command vehicle 移动指挥车

  43. Rapid Detection Test Kit快速诊断试剂盒 Bioterror pathogen and toxin test Kit 生物恐怖病原体和毒素试剂盒 Anthrax Spore test Kit 炭疽孢子试剂盒 Botulinum toxin test Kit 波特淋菌毒素试剂盒

  44. Absence of Evidence is not Evidence of Absence Thank you

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