MINISTRY OF HEALTH ACTION PLAN

1. MINISTRY OF HEALTH ACTION PLAN FOR THE PREVENTION AND CONTROL OF ANTHRAX Dr. Marion BullockDuCasse, SMO(H) Director, Emergency, Disaster Management and Special Services, 2001 / 10 / 20

2. FACTORS TO CONSIDER • Increased terrorist activity • Vulnerability of our people and country • Threat of chemical and biological warfare

3. FACTORS TO CONSIDER • Proximity to the USA • Air travel patterns • Incubation period – a few hours - 7 days and up to 60 days

4. Scenarios for humans • Individual exposure • Contaminated animals, meat or animal products • Contaminated mail • Mass exposure • Aerosolized particles

5. Other Scenarios • Importation of: • Contaminated animals • Contaminated meats • Contaminated animal products

6. THE PLAN • Covers all phases of management of Anthrax for the health sector • Prevention • Mitigation • Preparedness • Response • Recovery

7. THE FOCUS • The prevention and control of Anthrax, in order to minimize transmission, morbidity and mortality

8. The Plan • Will be a part of the MOH Emergency and Disaster Management Plan and is to be used in conjunction with it • Is a part of the MOH and National Plans for Response to Threats From Biological and Chemical Agents • Is therefore a part of the National Disaster Plan

9. OBJECTIVES • To detail all procedures, guidelines and actions to be taken by the heath sector for the prevention and control of Anthrax • To outline the steps to be taken by other Ministries and agencies

10. AUTHORITY • The plan is the authoritative guide of the health sector, for all actions required to effectively and efficiently deal with the health aspects of Anthrax exposure, infections and epidemics

11. AUTHORITY (cont.) • The MOH is the lead agency • All other agencies involved in the prevention and control of Anthrax must work in close collaboration with the MOH

12. ACTIVATION • Any suspected or confirmed caseof Anthrax or exposure to the Anthrax organism will necessitate activation of the plan and initiation of the response phase

13. ACTIVATION • The Plan will be activated by: • CMO • PS • Senior Medical Officer (Health) / Director, Emergency and Disaster Management

14. ACTIVATION • Once activation takes place: • The National Disaster Executive, and • All other relevant Ministries and agencies are then notified.

15. ACTION PLAN • Actions are listed for each phase • Not to be carried out sequentially • Many will have to be carried out simultaneously • Hence, the need for early notification and call-out of the Response Team

16. PREVENTION

17. PREVENTION

18. MITIGATION

19. PREPAREDNESS

20. PREPAREDNESS

21. Response – National Plan • Level 1 • External situation exists which could pose a threat to the country • No evidence of illness or disease or any agent that would cause illness or disease in the country

22. Response – National Plan • Level 2 • Investigation Response Team is called upon to respond to the possibility of existence of these agents • MOH Action Plan activated • MOH EOC partially activated

23. Response – Level 3 • Cases of illness or disease or presence of the agent would be confirmed (dependent on number of cases / advise of MOH or other sector with responsibility for confirmation) • FULL ACTIVATION OF THE NEOC • FULL ACTIVATION OF THE MOH EOC

24. RESPONSE - MOH • Will be initiated in two (2) phases • The Alert Phase / Partial Response • The Full Response

25. THE RESPONSE – Alert Phase and Full Response • Will be initiated by the MOH, in accordance with the guidelines of this Plan • Once a notification is received of a suspected case of Anthrax or the presence of a suspicious substance, letter, package or other material

26. THE ALERT PHASE • For suspected cases: • Includes those actions taken from the time of INITIAL NOTIFICATION • until CONFIRMATION OF THE DIAGNOSIS by the MOH, whether by clinical and epidemiological or laboratory means

27. ALERT PHASE – ACTION PLAN • Verify the presence of a suspicious substance, letter, package • Place Investigation Response Team on ALERT

28. Alert Phase • Verify the diagnosis of a case (suspected or confirmed) • Initiate actions in patient management protocol

29. ALERT PHASE • Confirm if case (suspected or confirmed) meets the diagnostic criteria – clinical and epidemiological or laboratory

30. THE ALERT PHASE • For a suspicious letter, package or other material: • Includes those actions taken from the NOTIFICATION • until VERIFICATION of its existence

32. FULL RESPONSE • Actions taken once the diagnosis of a suspected case is CONFIRMED by the MOH, or • the presence of a suspicious substance, letter, package or material is VERIFIED, • until DEACTIVATION of the Response

33. Full Response

34. Full Response

35. Full Response

36. Full Response

37. RECOVERY • Actions in this Phase will return activities of all sectors to those routine activities which were in place before the response to Anthrax

38. DEBRIEFING • A debriefing meeting will be convened by the SMO(H) / Director, EDMSS within seven (7) days of deactivation

39. FINAL REPORT • Will be prepared within fourteen (14) days of the deactivation and seven (7) days of the debriefing