Embed Size (px)
Citation preview
WHO Communicable Diseases, Surveillance & Response (CSR)
World Health AssemblyWorld Health AssemblyKey resolutions related to Global Alert & Response
1995 WHA Resolution on:Emerging diseases and drug resistance
2001 WHA Resolution on:Global Health Security, epidemic alert and response
2002 WHA Resolution on:Global public health response to () deliberate use of biologicaland chemical agents ()
2003 WHA Resolution on: Revision of the International Health Regulations and SARS; Influenza pandemic; Smallpox
WHO Communicable Diseases, Surveillance & Response (CSR)
A global partnership (e.g. WHO Collaborating Centres, Global Outbreak Alert and Response Network)
A global network (192 Member States, 6 WHO Regional Offices, 141 WHO Countries Offices)
Dr Denise Dr Denise WerkerWerker, WHO Geneva, WHO Geneva Dr Robert Dr Robert BreimanBreiman, WHO Beijing, WHO Beijing Dr Dr HitochiHitochi OshitaniOshitani, WHO Manila, WHO Manila
WHO Alert & ResponseWHO Alert & Response
WHO Communicable Diseases, Surveillance & Response (CSR)
WHO Alert & Response WHO Alert & Response A Global Strategy
G L O B A L P A R T N E R S H I P
I N T E R N A T I O N A L H E A L T H R E G U L A T I O N S
Improve preparedness
Respond to the unexpected
Contain known risks
E P I D E M I C A L E R T & R E S P O N S E
WHO Communicable Diseases, Surveillance & Response (CSR)
WHO Alert & Response WHO Alert & Response Detecting and responding to SARS
G L O B A L P A R T N E R S H I P
I N T E R N A T I O N A L H E A L T H R E G U L A T I O N S
Improve preparedness
Respond to the unexpected
Contain known risks
E P I D E M I C A L E R T & R E S P O N S E
Global Influenza
Programme
Global Influenza
Programme
Epidemic IntelligenceEpidemic
Intelligence
GOAR NetworkGOAR
Network BiosafetyBiosafety
Travel-related RecommendationsTravel-related Recommendations
CommunicationCommunication
Regional Offices: WPRO, AMRO, EURO, ...Regional Offices: WPRO, AMRO, EURO, ...
WR VietnamWR ChinaWR ThailandWR Singapore...
WR VietnamWR ChinaWR ThailandWR Singapore...
WHO Communicable Diseases, Surveillance & Response (CSR)
WHO Alert & ResponseWHO Alert & ResponseDetecting and responding to SARS (1)
1) Virtual network for SARS aetiology13 laboratories in 9 countries, daily telephone conference
identification of SARS coronavirus
face-to-face/video meeting, 16 April 2003
2) Virtual network of SARS clinicians50+ clinicians in 14 countries, telephone conference twice a week
case definition
infection control guidelines
face-to-face meeting, 14 June 2003
WHO Communicable Diseases, Surveillance & Response (CSR)
WHO Alert & ResponseWHO Alert & ResponseSARS WHO Guidelines (1)
Guidance for mass gatherings: hosting persons arriving from an area with recent local transmission of SARS - 15 May 2003
WHO Recommendations on SARS and Blood Safety - 15 May 2003
First data on stability and resistance of SARS coronavirus compiled by members of WHO laboratory network - 4 May 2003
Epidemic curves: SARS - 2 May 2003
Case definitions for Surveillance of SARS - 1 May 2003
Sampling for SARS diagnostic tests - 29 April 2003
SARS: Laboratory diagnostic tests - 29 April 2003
Recommendations for laboratories testing for SARS using polymerase chain reaction (PCR) for detection of SARS-CoV virus - 29 April 2003
WHO Communicable Diseases, Surveillance & Response (CSR)
WHO Alert & ResponseWHO Alert & ResponseSARS WHO Guidelines (2)
WHO biosafety guidelines for handling of SARS specimens - 25 April 2003Hospital Infection Control Guidance for SARS - 24 April 2003Information to Member States regarding goods and animals arriving from SARS-affected areas – 11 April 2003Management of SARS - 11 April 2003Weekly Epidemiological Record, 4 April 2003 - WHO recommended measures for persons undertaking international travel from areas affected by SARS; - Global surveillance for SARS;- SARS: case reporting formWHO hospital discharge and follow-up policy for patients who have been diagnosed with SARS – 28 March 2003Preliminary clinical description of SARS - 21 March 2003Severe Acute Respiratory Syndrome (SARS) - 21 March 2003
WHO Communicable Diseases, Surveillance & Response (CSR)
3) Virtual network of SARS epidemiologists32 epidemiologists, 11 institutions, daily telephone conferenceprovision of data and specific studiesface-to-face/audio/video meeting, 16-17 May 2003
4) Global Outbreak Alert & Response Network115 experts from 26 institutions in 17 countriesfield teams sent to 5 countries
5) Modelling group10 institutions, secure web site
WHO Alert & ResponseWHO Alert & ResponseDetecting and responding to SARS (2)
WHO Communicable Diseases, Surveillance & Response (CSR)
International Federation of Red Cross Australian Collaborative Research Centre for Emerging Infectious Diseases Centers for Disease Control and Prevention (CDC), USA Centre for Health and Population Research (ICDDRB), Bangladesh Centre for International Health, Curtin University, Australia EPICENTRE, Centre for Research in Epidemiology and Control of Emerging Diseases, France EPIET, the European Programme for Intervention Epidemiology Field Epidemiology Programmes in Australia, Japan and Thailand Global Emerging Infections System (GEIS), USA Health Canada Health Protection Agency (HPA), United Kingdom MSF - Belgium MSF - Switzerland
WHO Alert & Response WHO Alert & Response Global partnership for SARS control (1)
WHO Communicable Diseases, Surveillance & Response (CSR)
Institut National de Veille Sanitaire, France Institut Pasteur, Paris, FranceInstituts Pasteur, Vietnam Kunskapscentrum för Mikrobiologisk Beredskap (KCB), Smittskyddsinstitutet(SMI), Sweden Leicester Royal Infirmary, North Manchester General Hospital, United Kingdom National institute of Infectious Disease, Japan Robert Koch-Institute, Germany University Hospital, Frankfurt , GermanyNational Institute of Public Health, Section for Infectious Disease Control, Norway, Southern Cone Surveillance Network and Epidemiology Department, MoH, ChileNational Board of Health and Welfare and SIDA, Sweden UNDP Pacific Public Health Surveillance Network
WHO Alert & Response WHO Alert & Response Global partnership for SARS control (2)
WHO Communicable Diseases, Surveillance & Response (CSR)
6) Global WHO Senior Management Grouptelephone conference twice a week (HQ, ROs, WROs)since 15 March: 18 travel recommendations
7) Communication group 14 press releases, 13 press conferences, numerous interviewsup to 3 500 press stories per day 72 Web situation reports since 12 March 2003up to 10 million Web hits per day
WHO Alert & ResponseWHO Alert & ResponseDetecting and responding to SARS (3)
WHO Communicable Diseases, Surveillance & Response (CSR)
WHO Alert & ResponseWHO Alert & Responsewww.who.int / www.wpro.who.int
WHO Communicable Diseases, Surveillance & Response (CSR)
Active surveillance- Rapid detection and immediate isolation of cases - Strict infection control measures
Identification and follow-up of all contacts- Thorough investigation of all cases history- Daily follow-up for 10 days
Implementation of WHO travel recommendations- Travellers’ awareness- Exit screening of travellers leaving areas with local transmission- Postpone all but essential travel to severely affected areas
WHO Alert & ResponseWHO Alert & ResponseSARS control measures
WHO Communicable Diseases, Surveillance & Response (CSR)
Probable cases of SARS by date of onset, Viet Nam (n=61*)1 February - 7 April 2003
0
1
2
3
4
5
6
7
8
9
10
1-Feb-03 8-Feb-03 15-Feb-03 22-Feb-03 1-Mar-03 8-Mar-03 15-Mar-03 22-Mar-03 29-Mar-03 5-Apr-03
date of onset
num
ber o
f cas
es
Probable Cases of SARS by date of onset, Singapore (n=112*)1 February - 7 April 2003
0
2
4
6
8
10
12
14
1-Feb-03 8-Feb-03 15-Feb-03 22-Feb-03 1-Mar-03 8-Mar-03 15-Mar-03 22-Mar-03 29-Mar-03 5-Apr-03
date of onset
num
ber o
f cas
es
Probable cases of SARS by date of onset, Canada (n=75*)1 February - 7 April 2003
0
1
2
3
4
5
6
7
8
9
10
1-Feb-03 8-Feb-03 15-Feb-03 22-Feb-03 1-Mar-03 8-Mar-03 15-Mar-03 22-Mar-03 29-Mar-03 5-Apr-03
date of onset
num
ber o
f cas
es
Hanoi
SingaporeToronto
0
2 0
4 0
6 0
8 0
1 0 0
1 2 0
1 - F e b - 0 3 1 1 - F e b - 0 3 2 1 - F e b - 0 3 3 - M a r - 0 3 1 3 - M a r - 0 3 2 3 - M a r - 0 3 2 - A p r - 0 3 1 2 - A p r - 0 3 2 2 - A p r - 0 3 2 - M a y - 0 3 1 2 - M a y - 0 3
d a t e o f o n s e t
Hong Kong
WHO Alert & ResponseWHO Alert & ResponseSARS success stories
WHO Communicable Diseases, Surveillance & Response (CSR)
Virus origin
Virus stability under different environmental conditions
Role of asymptomatic infected individuals
Role of products of human origin
Virus pathogenicity
Use of antiviral drugs
Vaccine development
Evaluation of traveller exit screening methods
SARS epidemic modelling
WHO Alert & ResponseWHO Alert & ResponseSARS research
WHO Communicable Diseases, Surveillance & Response (CSR)
Communication is keybetween WHO and countrieswith the public and the mediamultisector event (health, economy, etc.)
Evidence-based actionefficient alert and response system in all countries rapid sharing of data/information
Global partnershipno country can do it alone, all resources needed unique role of WHO: technical, neutral, privileged access to all countries
WHO Alert & ResponseWHO Alert & ResponseSARS, lessons learned
WHO Communicable Diseases, Surveillance & Response (CSR)
WHO Alert & Response WHO Alert & Response SARS, lessons learned for IHR revision
Timely reporting- advocate transparency- delay between different administrative levels
Use of different information sources- Ministry of Health, WHO Collaborating Centres, UN system, NGOs, media...
Need for “operational interface” country/WHO- need for rapid consultation of countries
- “Operational arm” of the IHR at global and regional level
WHO Communicable Diseases, Surveillance & Response (CSR)
Thank youThank you
Microbes are unpredictable!
Some WHOSome WHO--facilitated epidemic response in the field, 1998facilitated epidemic response in the field, 1998––20032003
