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Communicable Disease Control in Emergencies Idris Al abadaini DCDS&C. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman. Outline. Disease Early Warning System Communicable Diseases (CD) basic principles. Major disease threats in emergencies
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Communicable Disease Control in EmergenciesIdris Al abadainiDCDS&C First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Outline • Disease Early Warning System • Communicable Diseases (CD) basic principles. • Major disease threats in emergencies • Surveillance/DEWOS • Outbreak Control • Preparedness • Detection • Confirmation • Response • Evaluation
Resource: The Johns hopkins and IFRC Public Health Guide for emergency Outbreak: the occurrence of cases of an illness with a frequency that is clearly in excess of what is expected in a given region, therefore demanding emergency control measures
Q) What are these factors? Failure in disease prevention outbreak
Priority CD Interventions • Emergency medical and surgical care • Safe water and adequate sanitation/hygiene • Provision of safe food • Provision of shelter (site planning) • Immunization (measles = 1st priority, later restart routine EPI) • Access to 1° & 2° health services (case management) • Disease surveillance/outbreak preparedness & control • Vector control • Environmental sanitation / waste disposal • Health education
PREVENTION OF AN OUTBREAK • Hygienic disposal of human feces • Sufficient and safe water supply • Hand-washing with soap • Health promotion • Food safety • Adequate living space • Adequate shelter • Nutrition • Medical intervention • Handling dead bodies • Vector control
Q) What are these factors? Failure in disease prevention outbreak
Failure in disease prevention • Lack of political commitments and funding • Poor surveillance system • Unskilled health care workers • Inadequate or incomplete case Tx • Over-reliance on preventive measures, e.g., chlorination of water, immunization, etc..
Outbreak Control • Preparedness • Detection • Confirmation • Response • Evaluation
preparedness • Surveillance System/DEWOS, in place. • An outbreak response plan is written for the disease-covering resource, skills and activities required.
preparedness • Standard treatment protocols • Stockpiles of: • Essential treatment supplies • Essential Laboratory sampling kits • PPEs • Vaccine supplies • Availability/security of cold chain are established.
Resource needed for outbreak response (examples) • Trained personnel • Suppliers (ORS, vaccines, vitamin A, iv fluids etc.. • Treatment facilities (location, beds available) • Laboratory facilities • Transport (source of emergency transport and fuel, cold chain) • Communication • PCs • If vaccination required; • AD syringes • Vaccination facilities • Cold chain equipments
Detection • Surveillance/epidemic thresholds • Outbreak control /Rapid response team • Composition • TOR • Implementation of preparedness & response plan • Resource mobilization • Coordination • Information disimination
conformation • Laboratory conformation: • Collection of samples • Transportation of samples • Safe packaging • Tasting samples • Reporting/interpreting results
response • Collection/analysis of descriptive data and development of hypothesis • Extent of the outbreak • Severity
Response • Follow-up of cases and contacts • Active case finding • Contact traicing • Further investigation/epidemiological studies • Case-control/cohort studies • Environmental investigations • Control • Prevention of exposure • Prevention of infection • Prevention of diseases • Prevention of death
Response • Patient isolation • Bio-hazardious materials -safe disposal of body fluids is essential especially in highly contagious diseases. • Sharp objects disposal. • Proper diagnosis and effective mangment
Evaluation • Cause of the outbreak • Surveillance and detection of an outbreak. • Preparedness • Management • Control measures • feedback