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Sample records for managing emerging infectious

  1. Emergent Infectious Uveitis

    PubMed Central

    Khairallah, Moncef; Jelliti, Bechir; Jenzeri, Salah

    2009-01-01

    Infectious causes should always be considered in all patients with uveitis and it should be ruled out first. The differential diagnosis includes multiple well-known diseases including herpes, syphilis, toxoplasmosis, tuberculosis, bartonellosis, Lyme disease, and others. However, clinicians should be aware of emerging infectious agents as potential causes of systemic illness and also intraocular inflammation. Air travel, immigration, and globalization of business have overturned traditional pattern of geographic distribution of infectious diseases, and therefore one should work locally but think globally, though it is not possible always. This review recapitulates the systemic and ocular mainfestations of several emergent infectious diseases relevant to the ophthalmologist including Rickettsioses, West Nile virus infection, Rift valley fever, dengue fever, and chikungunya. Retinitis, chorioretinitis, retinal vasculitis, and optic nerve involvement have been associated with these emergent infectious diseases. The diagnosis of any of these infections is usually based on pattern of uveitis, systemic symptoms and signs, and specific epidemiological data and confirmed by detection of specific antibody in serum. A systematic ocular examination, showing fairly typical fundus findings, may help in establishing an early clinical diagnosis, which allows prompt, appropriate management. PMID:20404989

  2. Using decision analysis to support proactive management of emerging infectious wildlife diseases

    USGS Publications Warehouse

    Grant, Evan H. Campbell; Muths, Erin L.; Katz, Rachel A.; Canessa, Stefano; Adams, Michael J.; Ballard, Jennifer R.; Berger, Lee; Briggs, Cheryl J.; Coleman, Jeremy; Gray, Matthew J.; Harris, M. Camille; Harris, Reid N.; Hossack, Blake R.; Huyvaert, Kathryn P.; Kolby, Jonathan E.; Lips, Karen R.; Lovich, Robert E.; McCallum, Hamish I.; Mendelson, Joseph R.; Nanjappa, Priya; Olson, Deanna H.; Powers, Jenny G.; Richgels, Katherine L.D.; Russell, Robin E.; Schmidt, Benedikt R.; Spitzen-van der Sluijs, Annemarieke; Watry, Mary Kay; Woodhams, Douglas C.; White, C. LeAnn

    2017-01-01

    Despite calls for improved responses to emerging infectious diseases in wildlife, management is seldom considered until a disease has been detected in affected populations. Reactive approaches may limit the potential for control and increase total response costs. An alternative, proactive management framework can identify immediate actions that reduce future impacts even before a disease is detected, and plan subsequent actions that are conditional on disease emergence. We identify four main obstacles to developing proactive management strategies for the newly discovered salamander pathogen Batrachochytrium salamandrivorans (Bsal). Given that uncertainty is a hallmark of wildlife disease management and that associated decisions are often complicated by multiple competing objectives, we advocate using decision analysis to create and evaluate trade-offs between proactive (pre-emergence) and reactive (post-emergence) management options. Policy makers and natural resource agency personnel can apply principles from decision analysis to improve strategies for countering emerging infectious diseases.

  3. Using decision analysis to support proactive management of emerging infectious wildlife diseases

    Treesearch

    Evan H Campbell Grant; Erin Muths; Rachel A Katz; Stefano Canessa; Michael J Adams; Jennifer R Ballard; Lee Berger; Cheryl J Briggs; Jeremy TH Coleman; Matthew J Gray; M Camille Harris; Reid N Harris; Blake Hossack; Kathryn P Huyvaert; Jonathan Kolby; Karen R Lips; Robert E Lovich; Hamish I McCallum; Joseph R Mendelson; Priya Nanjappa; Deanna H Olson; Jenny G Powers; Katherine LD Richgels; Robin E Russell; Benedikt R Schmidt; Annemarieke Spitzen-van der Sluijs; Mary Kay Watry; Douglas C Woodhams; C LeAnn White

    2017-01-01

    Despite calls for improved responses to emerging infectious diseases in wildlife, management is seldom considered until a disease has been detected in affected populations. Reactive approaches may limit the potential for control and increase total response costs. An alternative, proactive management framework can identify immediate actions that reduce future impacts...

  4. Emerging Infectious Diseases in Pregnancy.

    PubMed

    Beigi, Richard H

    2017-05-01

    It has been recognized for centuries that pregnant women have unique susceptibilities to many infectious diseases that predispose them to untoward outcomes compared with the general adult population. It is thought a combination of adaptive alterations in immunity to allow for the fetal allograft combined with changes in anatomy and physiology accompanying pregnancy underlie these susceptibilities. Emerging infectious diseases are defined as those whose incidence in humans has increased in the past two decades or threaten to increase in the near future. The past decade alone has witnessed many such outbreaks, each with its own unique implications for pregnant women and their unborn fetuses as well as lessons for the health care community regarding response and mitigation. Examples of such outbreaks include, but are not limited to, severe acute respiratory syndrome, the 2009 H1N1 pandemic influenza, Ebola virus, and, most recently, the Zika virus. Although each emerging pathogen has unique features requiring specific considerations, there are many underlying principles that are shared in the recognition, communication, and mitigation of such infectious outbreaks. Some of these key principles include disease-specific delineation of transmission dynamics, understanding of pathogen-specific effects on both mothers and fetuses, and advance planning and contemporaneous management that prioritize communication among public health experts, clinicians, and patients. The productive and effective working collaboration among the Centers for Disease Control and Prevention, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine has been a key partnership in the successful communication and management of such outbreaks for women's health care providers and patients alike. Going forward, the knowledge gained over the past decade will undoubtedly continue to inform future responses and will serve to optimize the education and care given

  5. Conflict and Emerging Infectious Diseases

    PubMed Central

    Legros, Dominique; Formenty, Pierre; Connolly, Maire A.

    2007-01-01

    Detection and control of emerging infectious diseases in conflict situations are major challenges due to multiple risk factors known to enhance emergence and transmission of infectious diseases. These include inadequate surveillance and response systems, destroyed infrastructure, collapsed health systems and disruption of disease control programs, and infection control practices even more inadequate than those in resource-poor settings, as well as ongoing insecurity and poor coordination among humanitarian agencies. This article outlines factors that potentiate emergence and transmission of infectious diseases in conflict situations and highlights several priority actions for their containment and control. PMID:18217543

  6. Role of molecular diagnostics in the management of infectious disease emergencies.

    PubMed

    Krishna, Neel K; Cunnion, Kenji M

    2012-11-01

    In the setting of infectious disease emergencies, rapid and accurate identification of the causative agent is critical to optimizing antimicrobial therapy in a timely manner. It is clearly evident that the age of molecular diagnostics is now upon us, with real-time PCR becoming the standard of diagnosis for many infectious disease emergencies in either monoplex or multiplex format. Other molecular techniques such as whole or partial genome sequencing, microarrays, broad-range PCR, restriction fragment length polymorphisms, and molecular typing are also being used. However, for most small clinical laboratories, implementation of these advanced molecular techniques is not feasible owing to the high cost of instrumentation and reagents. If these tests are not available in-house, samples can be sent to national reference laboratories (eg, Mayo Medical Laboratories and Quest Diagnostics) for real-time PCR assays that can be completed in 1 day. It is anticipated that over time commercial real-time PCR tests and instrumentation will become more standardized and affordable, allowing individual laboratories to conduct tests locally, thus further reducing turnaround time. Although real-time PCR has been proved to expand our diagnostic capability, it must be stressed that such molecular methodology constitutes only an additional tool in the diagnosis of infectious diseases in emergency situations. Phenotypic methodologies (staining, cultures, biochemical tests, and serology) still play a critical role in identifying, confirming, and providing antibiotic susceptibility testing for many microbial pathogens. As multiplex assays become increasingly available, there will be even greater temptation for taking a “shotgun” approach to diagnostic testing. These new technologies will not substitute for a proper history and physical examination leading to a thoughtful differential diagnosis. None the less, these new molecular tests increase the capability of the diagnostician to

  7. Effective Coordination and Management of Emerging Infectious Diseases in Wildlife Populations.

    PubMed

    Hyatt, Alex; Aguirre, A Alonso; Jeggo, Martyn; Woods, Rupert

    2015-09-01

    A transdisciplinary, One Health approach is proposed for the coordination of wildlife health diagnostics, research, and policy development. In some countries, considerable effort has been made to establish specific activities including surveillance and integration of wildlife health within diagnostic and research laboratories. We suggest that some of these activities can be improved and many countries still require national structures to deal with wildlife disease investigation and management. We also suggest that scientists in this field should actively engage with national and international organizations and conferences to influence the development of policy, diagnostics, research, and management of emerging wildlife diseases.

  8. Knowledge Management Framework for Emerging Infectious Diseases Preparedness and Response: Design and Development of Public Health Document Ontology.

    PubMed

    Zhang, Zhizun; Gonzalez, Mila C; Morse, Stephen S; Venkatasubramanian, Venkat

    2017-10-11

    There are increasing concerns about our preparedness and timely coordinated response across the globe to cope with emerging infectious diseases (EIDs). This poses practical challenges that require exploiting novel knowledge management approaches effectively. This work aims to develop an ontology-driven knowledge management framework that addresses the existing challenges in sharing and reusing public health knowledge. We propose a systems engineering-inspired ontology-driven knowledge management approach. It decomposes public health knowledge into concepts and relations and organizes the elements of knowledge based on the teleological functions. Both knowledge and semantic rules are stored in an ontology and retrieved to answer queries regarding EID preparedness and response. A hybrid concept extraction was implemented in this work. The quality of the ontology was evaluated using the formal evaluation method Ontology Quality Evaluation Framework. Our approach is a potentially effective methodology for managing public health knowledge. Accuracy and comprehensiveness of the ontology can be improved as more knowledge is stored. In the future, a survey will be conducted to collect queries from public health practitioners. The reasoning capacity of the ontology will be evaluated using the queries and hypothetical outbreaks. We suggest the importance of developing a knowledge sharing standard like the Gene Ontology for the public health domain.

  9. A proposed emergency management program for acute care facilities in response to a highly virulent infectious disease.

    PubMed

    Petinaux, Bruno; Ferguson, Brandy; Walker, Milena; Lee, Yeo-Jin; Little, Gary; Parenti, David; Simon, Gary

    2016-01-01

    To address the organizational complexities associated with a highly virulent infectious disease (HVID) hazard, such as Ebola Virus Disease (EVD), an acute care facility should institute an emergency management program rooted in the fundamentals of mitigation, preparedness, response, and recovery. This program must address all known facets of the care of a patient with HVID, from unannounced arrival to discharge. The implementation of such a program not only serves to mitigate the risks from an unrecognized exposure but also serves to prepare the organization and its staff to provide for a safe response, and ensure a full recovery. Much of this program is based on education, training, and infection control measures along with resourcing for appropriate personal protective equipment which is instrumental in ensuring an organized and safe response of the acute care facility in the service to the community. This emergency management program approach can serve as a model in the care of not only current HVIDs such as EVD but also future presentations in our healthcare setting.

  10. Infectious diseases specialist management improves outcomes for outpatients diagnosed with cellulitis in the emergency department: a double cohort study.

    PubMed

    Jain, Shilpa R; Hosseini-Moghaddam, Seyed M; Dwek, Philip; Gupta, Kaveri; Elsayed, Sameer; Thompson, Guy W; Dagnone, Robert; Hutt, Kelly; Silverman, Michael

    2017-04-01

    Three hospital emergency rooms (ERs) routinely referred all cases of cellulitis requiring outpatient intravenous antibiotics, to a central ER-staffed cellulitis clinic. We performed a retrospective cohort study of all patients seen by the ER clinic in the last 4months preceding a policy change (ER management cohort [ERMC]) (n=149) and all those seen in the first 3months of a new policy of automatic referral to an infectious disease (ID) specialist-supervised cellulitis clinic (ID management cohort [IDMC]) (n=136). Fifty-four (40%) of 136 patients in the IDMC were given an alternative diagnosis (noncellulitis), compared to 16 (11%) of 149 in the ERMC (P<0.0001). Logistic regression-demonstrated rates of disease recurrence were lower in the IDMC than the ERMC (hazard ratio [HR], 0.06; P=0.003), as were rates of hospitalization (HR, 0.11; P=0.01). There was no significant difference in mortality. Automatic ID consultation for cellulitis was beneficial in differentiating mimickers from true cellulitis, reducing recurrence, and preventing hospital admissions. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Managing an Infectious Disease Outbreak in a School. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 3

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an infectious disease incident, which resulted in the death of a student, closure of area schools and the operation of an on-site school vaccine clinic. The report highlights the critical need…

  12. Moving Beyond Too Little, Too Late: Managing Emerging Infectious Diseases in Wild Populations Requires International Policy and Partnerships

    Treesearch

    Jamie Voyles; A. Marm Kilpatrick; James P. Collins; Matthew C. Fisher; Winifred F. Frick; Hamish McCallum; Craig K. R. Willis; David S. Blehert; Kris A. Murray; Robert Puschendorf; Erica Bree Rosenblum; Benjamin M. Bolker; Tina L. Cheng; Kate E. Langwig; Daniel L. Lindner; Mary Toothman; Mark Q. Wilber; Cheryl J. Briggs

    2015-01-01

    Emerging infectious diseases (EIDs) are on the rise due to multiple factors, including human facilitated movement of pathogens, broad-scale landscape changes, and perturbations to ecological systems (Jones et al. 2008; Fisher et al. 2012). Epidemics in wildlife are problematic because they can lead to pathogen spillover to new host organisms, erode biodiversity and...

  13. Infectious diseases team for the early management of severe sepsis and septic shock in the emergency department.

    PubMed

    Viale, Pierluigi; Tedeschi, Sara; Scudeller, Luigia; Attard, Luciano; Badia, Lorenzo; Bartoletti, Michele; Cascavilla, Alessandra; Cristini, Francesco; Dentale, Nicola; Fasulo, Giovanni; Legnani, Giorgio; Trapani, Filippo; Tumietto, Fabio; Verucchi, Gabriella; Virgili, Giulio; Berlingeri, Andrea; Ambretti, Simone; De Molo, Chiara; Brizi, Mara; Cavazza, Mario; Giannella, Maddalena

    2017-06-12

    To assess the impact on all-cause 14-day survival of the implementation of an infectious disease (ID) team for the early management of severe sepsis/septic shock (SS/SS) in the Emergency Department (ED). A quasi-experimental pre-post study was carried-out at the general ED of our 1,420-bed teaching hospital. During the pre phase (June 2013-July 2014) all consecutive adult patients with SS/SS were managed according to standard-of-care and data were prospectively collected. During the post phase (August 2014-October 2015), patients were managed in collaboration with a dedicated ID team by a bedside patient evaluation within 1 hour from ED arrival. Overall, 382 patients were included, 195 in the pre and 187 in the post phase. Median age was 82 years (IQR 70-88). Most common infection sources were lung (43%) and urinary tract (17%), in 22% of cases infection source remained unknown. During the post phase the overall compliance with the Surviving Sepsis Campaign (SSC) bundle and the appropriateness of initial antibiotic therapy improved from 4.6% to 32% (P<0.001), and from 30% to 79% (P<0.001), respectively. At multivariate analysis, predictors of 14-day mortality were: qSOFA ≥ 2 [HR 1.68, 1.15-2.45, P=0.007], serum lactate ≥ 2 mmol/L [HR 2.13, 1.39-3.25, P<0.001], and unknown infection source [HR 2.07, 1.42-3.02, P<0.001], while being attended during the post phase was a protective factor [HR 0.64, 0.43-0.94, P=0.026]. The implementation of an ID team dedicated to the early management of SS/SS in ED improved the adherence to SSC recommendation and patient survival.

  14. Emerging and Neglected Infectious Diseases: Insights, Advances, and Challenges

    PubMed Central

    2017-01-01

    Infectious diseases are a significant burden on public health and economic stability of societies all over the world. They have for centuries been among the leading causes of death and disability and presented growing challenges to health security and human progress. The threat posed by infectious diseases is further deepened by the continued emergence of new, unrecognized, and old infectious disease epidemics of global impact. Over the past three and half decades at least 30 new infectious agents affecting humans have emerged, most of which are zoonotic and their origins have been shown to correlate significantly with socioeconomic, environmental, and ecological factors. As these factors continue to increase, putting people in increased contact with the disease causing pathogens, there is concern that infectious diseases may continue to present a formidable challenge. Constant awareness and pursuance of effective strategies for controlling infectious diseases and disease emergence thus remain crucial. This review presents current updates on emerging and neglected infectious diseases and highlights the scope, dynamics, and advances in infectious disease management with particular focus on WHO top priority emerging infectious diseases (EIDs) and neglected tropical infectious diseases. PMID:28286767

  15. Emerging and Neglected Infectious Diseases: Insights, Advances, and Challenges.

    PubMed

    Nii-Trebi, Nicholas Israel

    2017-01-01

    Infectious diseases are a significant burden on public health and economic stability of societies all over the world. They have for centuries been among the leading causes of death and disability and presented growing challenges to health security and human progress. The threat posed by infectious diseases is further deepened by the continued emergence of new, unrecognized, and old infectious disease epidemics of global impact. Over the past three and half decades at least 30 new infectious agents affecting humans have emerged, most of which are zoonotic and their origins have been shown to correlate significantly with socioeconomic, environmental, and ecological factors. As these factors continue to increase, putting people in increased contact with the disease causing pathogens, there is concern that infectious diseases may continue to present a formidable challenge. Constant awareness and pursuance of effective strategies for controlling infectious diseases and disease emergence thus remain crucial. This review presents current updates on emerging and neglected infectious diseases and highlights the scope, dynamics, and advances in infectious disease management with particular focus on WHO top priority emerging infectious diseases (EIDs) and neglected tropical infectious diseases.

  16. Infectious disease emergencies in primary care.

    PubMed

    Kwitkowski, V E; Demko, S G

    1999-01-01

    Infectious disease emergencies can be described as infectious processes that, if not recognized and treated immediately, can lead to significant morbidity or mortality. These emergencies can present as common or benign infections, fooling the primary care provider into using more conservative treatment strategies than are required. This review discusses the pathophysiology, history and physical findings, diagnostic criteria, and treatment strategies for the following infectious disease emergencies: acute bacterial meningitis, ehrlichiosis, Rocky Mountain spotted fever, meningococcemia, necrotizing soft tissue infections, toxic shock syndrome, food-borne illnesses, and infective endocarditis. Because most of the discussed infectious disease emergencies require hospital care, the primary care clinician must be able to judge when a referral to a specialist or a higher-level care facility is indicated.

  17. Towards effective emerging infectious disease surveillance.

    PubMed

    Ear, Sophal

    2014-01-01

    In this plenary talk given at the annual meeting of the Association for Politics and the Life Sciences at Texas Tech University last October, Professor Sophal Ear, then of the U.S. Naval Postgraduate School in Monterey, discussed his research on the political economy of emerging infectious disease (EID) surveillance programs. His talk reviews lessons learned for U.S. military medical research laboratories collaborating with developing countries and is comprised of three case studies: Cambodia (U.S. Naval Area Medical Research Unit 2 or NAMRU-2), Indonesia (also NAMRU-2 in the context of H5N1 or Highly Pathogenic Avian Influenza), (1) and Mexico (that country's handling of A/H1N1 or Swine Flu in 2009). (2) Professor Ear's research provides policymakers with tools for improving the effectiveness of new or existing EID surveillance programs. His work also offers host countries the opportunity to incorporate ideas, provide opinions, and debate the management of political and economic constraints facing their programs. In this analysis, constraints are found for each case study and general recommendations are given for improving global emerging infectious disease surveillance across political, economic, and cultural dimensions.

  18. Emerging infectious diseases and amphibian population declines.

    PubMed Central

    Daszak, P.; Berger, L.; Cunningham, A. A.; Hyatt, A. D.; Green, D. E.; Speare, R.

    1999-01-01

    We review recent research on the pathology, ecology, and biogeography of two emerging infectious wildlife diseases, chytridiomycosis and ranaviral disease, in the context of host-parasite population biology. We examine the role of these diseases in the global decline of amphibian populations and propose hypotheses for the origins and impact of these panzootics. Finally, we discuss emerging infectious diseases as a global threat to wildlife populations. PMID:10603206

  19. Emerging Infectious Diseases in Mongolia

    PubMed Central

    Altantsetseg, Togoo; Oyungerel, Ravdan

    2003-01-01

    Since 1990, Mongolia’s health system has been in transition. Impressive gains have been accomplished through a national immunization program, which was instituted in 1991. Nevertheless, the country continues to confront four major chronic infections: hepatitis B and C, brucellosis, tuberculosis, and sexually transmitted diseases (STDs). As of 2001, only two cases of HIV infections had been detected in Mongolia, but concern grows that the rate will increase along with the rising rates of STDs and increase in tourism. Other infectious diseases of importance in Mongolia include echinococcus, plague, tularemia, anthrax, foot-and-mouth, and rabies. PMID:14720388

  20. Moving beyond too little, too late: managing emerging infectious diseases in wild populations requires international policy and partnerships

    USGS Publications Warehouse

    Voyles, Jamie; Kilpatrick, A. Marm; Collins, James P.; Fisher, Matthew C.; Frick, Winifred F.; McCallum, Hamish I.; Willis, Craig K.R.; Blehert, David S.; Murray, Kris A.; Puschendorf, Robert; Rosenblum, Erica Bree; Bolker, Benjamin M.; Cheng, Tina L.; Langwig, Kate E.; Linder, Daniel L.; Toothman, Mary; Wilber, Mark Q.; Briggs, Cheryl J.

    2015-01-01

    Emerging infectious diseases (EIDs) are on the rise due to multiple factors, including human facilitated movement of pathogens, broad-scale landscape changes, and perturbations to ecological systems (Jones et al. 2008; Fisher et al. 2012). Epidemics in wildlife are problematic because they can lead to pathogen spillover to new host organisms, erode biodiversity and threaten ecosystems that sustain human societies (Fisher et al. 2012; Kilpatrick 2011). There have been recent calls for large-scale research approaches to combat threats EIDs pose to wildlife (Sleeman 2013). While it is true that developing new analytical models, diagnostic assays and molecular tools will significantly avance outr abilities to respond to disease threats, we also propose that addressing difficult problems in EIDs will require considerable shofts in international health policy and infrastructure. While there are currently international organizations responsbile for rapidly initiating and coordinating preventative measures to control infectious diseases in human, livestock, and arable systems, there are few comparable instiutions that have the authority to implement transnational responses to EIDs in wildlife. This absence of well-developed infastructure hampers the rapid responses necessary to mitigate international spread of EIDs.

  1. Selected emerging infectious diseases of squamata.

    PubMed

    Latney, La'toya V; Wellehan, James

    2013-05-01

    It is important that reptile clinicians have an appreciation for the epidemiology, clinical signs, pathology, diagnostic options, and prognostic parameters for novel and emerging infectious diseases in squamates. This article provides an update on emerging squamate diseases reported in the primary literature within the past decade. Updates on adenovirus, iridovirus, rhabdovirus, arenavirus, and paramyxovirus epidemiology, divergence, and host fidelity are presented. A new emerging bacterial disease of Uromastyx species, Devriesea agamarum, is reviewed. Chrysosporium ophiodiicola-associated mortality in North American snakes is discussed. Cryptosporidium and pentastomid infections in squamates are highlighted among emerging parasitic infections. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Self-disseminating vaccines for emerging infectious diseases

    PubMed Central

    Murphy, Aisling A.; Redwood, Alec J.; Jarvis, Michael A.

    2016-01-01

    Modern human activity fueled by economic development is profoundly altering our relationship with microorganisms. This altered interaction with microbes is believed to be the major driving force behind the increased rate of emerging infectious diseases from animals. The spate of recent infectious disease outbreaks, including Ebola virus disease and Middle East respiratory syndrome, emphasize the need for development of new innovative tools to manage these emerging diseases. Disseminating vaccines are one such novel approach to potentially interrupt animal to human (zoonotic) transmission of these pathogens. PMID:26524478

  3. Self-disseminating vaccines for emerging infectious diseases.

    PubMed

    Murphy, Aisling A; Redwood, Alec J; Jarvis, Michael A

    2016-01-01

    Modern human activity fueled by economic development is profoundly altering our relationship with microorganisms. This altered interaction with microbes is believed to be the major driving force behind the increased rate of emerging infectious diseases from animals. The spate of recent infectious disease outbreaks, including Ebola virus disease and Middle East respiratory syndrome, emphasize the need for development of new innovative tools to manage these emerging diseases. Disseminating vaccines are one such novel approach to potentially interrupt animal to human (zoonotic) transmission of these pathogens.

  4. Highlights from the 2014 International Symposium on HIV & Emerging Infectious Diseases (ISHEID): from cART management to the end of the HIV pandemic

    PubMed Central

    2014-01-01

    The 2014 International Symposium on HIV and Emerging Infectious Diseases (ISHEID) provided a forum for investigators to hear the latest research developments in the clinical management of HIV and HCV infections as well as HIV cure research. Combined anti-retroviral therapy (c-ART) has had a profound impact on the disease prognosis and transformed this infection into a chronic disease. However, HIV is able to persist within the infected host and the pandemic is still growing. The main 2014 ISHEID theme was, hence “Together for a world without HIV and AIDS”. In this report we not only give details on this main topic but also summarize what has been discussed in the areas of HCV coinfection and present a short summary on currently emerging viral diseases. PMID:25165483

  5. Travel and the emergence of infectious diseases.

    PubMed Central

    Wilson, M. E.

    1995-01-01

    Travel is a potent force in the emergence of disease. Migration of humans has been the pathway for disseminating infectious diseases throughout recorded history and will continue to shape the emergence, frequency, and spread of infections in geographic areas and populations. The current volume, speed, and reach of travel are unprecedented. The consequences of travel extend beyond the traveler to the population visited and the ecosystem. When they travel, humans carry their genetic makeup, immunologic sequelae of past infections, cultural preferences, customs, and behavioral patterns. Microbes, animals, and other biologic life also accompany them. Today's massive movement of humans and materials sets the stage for mixing diverse genetic pools at rates and in combinations previously unknown. Concomitant changes in the environment, climate, technology, land use, human behavior, and demographics converge to favor the emergence of infectious diseases caused by a broad range of organisms in humans, as well as in plants and animals. PMID:8903157

  6. Infection control management of patients with suspected highly infectious diseases in emergency departments: data from a survey in 41 facilities in 14 European countries

    PubMed Central

    2012-01-01

    Background In Emergency and Medical Admission Departments (EDs and MADs), prompt recognition and appropriate infection control management of patients with Highly Infectious Diseases (HIDs, e.g. Viral Hemorrhagic Fevers and SARS) are fundamental for avoiding nosocomial outbreaks. Methods The EuroNHID (European Network for Highly Infectious Diseases) project collected data from 41 EDs and MADs in 14 European countries, located in the same facility as a national/regional referral centre for HIDs, using specifically developed checklists, during on-site visits from February to November 2009. Results Isolation rooms were available in 34 facilities (82,9%): these rooms had anteroom in 19, dedicated entrance in 15, negative pressure in 17, and HEPA filtration of exhausting air in 12. Only 6 centres (14,6%) had isolation rooms with all characteristics. Personnel trained for the recognition of HIDs was available in 24 facilities; management protocols for HIDs were available in 35. Conclusions Preparedness level for the safe and appropriate management of HIDs is partially adequate in the surveyed EDs and MADs. PMID:22284435

  7. Social inequalities and emerging infectious diseases.

    PubMed Central

    Farmer, P.

    1996-01-01

    Although many who study emerging infections subscribe to social-production-of-disease theories, few have examined the contribution of social inequalities to disease emergence. Yet such inequalities have powerfully sculpted not only the distribution of infectious diseases, but also the course of disease in those affected. Outbreaks of Ebola, AIDS, and tuberculosis suggest that models of disease emergence need to be dynamic, systemic, and critical. Such models--which strive to incorporate change and complexity, and are global yet alive to local variation--are critical of facile claims of causality, particularly those that scant the pathogenic roles of social inequalities. Critical perspectives on emerging infections ask how large-scale social forces influence unequally positioned individuals in increasingly interconnected populations; a critical epistemology of emerging infectious diseases asks what features of disease emergence are obscured by dominant analytic frameworks. Research questions stemming from such a reexamination of disease emergence would demand close collaboration between basic scientists, clinicians, and the social scientists and epidemiologists who adopt such perspectives. PMID:8969243

  8. Emerging infectious diseases – 1970s

    PubMed Central

    Ferguson, Robert

    2016-01-01

    Forty years ago is not ancient history in the medical field. However, being an eye witness to the emergence of three new infectious diseases in the northeastern United States in the 1970s left a deep impression on this author. I will relate a small portion of the amazing events that caught the attention of the medical establishment and the general public in a roughly 5-year period of medical discovery. PMID:27802859

  9. Accelerated vaccine development against emerging infectious diseases.

    PubMed

    Leblanc, Pierre R; Yuan, Jianping; Brauns, Tim; Gelfand, Jeffrey A; Poznansky, Mark C

    2012-07-01

    Emerging and re-emerging infectious diseases represent a major challenge to vaccine development since it involves two seemingly contradictory requirements. Rapid and flexible vaccine generation while using technologies and processes that can facilitate accelerated regulatory review. Development in the "-omics" in combination with advances in vaccinology offer novel opportunities to meet these requirements. Here we describe how a consortium of five different organizations from academia and industry is addressing these challenges. This novel approach has the potential to become the new standard in vaccine development allowing timely deployment to avert potential pandemics.

  10. Opinion paper on innovative approach of biomarkers for infectious diseases and sepsis management in the emergency department.

    PubMed

    Di Somma, Salvatore; Magrini, Laura; Travaglino, Francesco; Lalle, Irene; Fiotti, Nicola; Cervellin, Grianfranco; Avanzi, Gian Carlo; Lupia, Enrico; Maisel, Alan; Hein, Frauke; Wagner, Florian; Lippi, Giuseppe

    2013-06-01

    Sepsis is a leading healthcare problem, accounting for the vast majority of fatal events in critically ill patients. Beyond early diagnosis and appropriate treatment, this condition requires a multifaceted approach for monitoring the severity, the potential organ failure as well as the risk of death. Monitoring of the efficacy of treatment is also a major issue in the emergency department (ED). The assessment of critically ill conditions and the prognosis of patients with sepsis is currently based on some scoring systems, which are, however, inefficient to provide definite clues about organ failure and prognosis in general. The discretionary and appropriate use of some selected biomarkers such as procalcitonin, inducible protein 10 (IP10), Group IV phospholipase A2 type II (PLA2 II), neutrophil gelatinase-associated lipocalin (NGAL), natriuretic peptides, mature adrenomedullin (ADM), mid-regional pro-adrenomedullin (MR-proADM), copeptin, thrombopoietin, Mer receptor and even red blood cell distribution width (RDW) represent thereby an appealing perspective in the diagnosis and management of patients with sepsis. Nevertheless, at the moment, it is not still clear if it is better to use a multimarkers approach or if a single, most appropriate, biomarker exists. This collective opinion paper is aimed at providing an overview about the potential clinical usefulness of some innovative biomarkers of sepsis in its diagnosis and prognosis, but also in the treatment management of the disease. This manuscript represents a synopsis of the lectures of Third Italian GREAT Network Congress, that was hold in Rome, 15-19 October 2012.

  11. Lurking in the Shadows: Emerging Rodent Infectious Diseases

    PubMed Central

    Besselsen, David G.; Franklin, Craig L.; Livingston, Robert S.; Riley, Lela K.

    2013-01-01

    Rodent parvoviruses, Helicobacter spp., murine norovirus, and several other previously unknown infectious agents have “emerged” in laboratory rodents relatively recently. These agents have been discovered serendipitously or through active investigation of atypical serology results, cell culture contamination, unexpected histopathology, or previously unrecognized clinical disease syndromes. The potential research impact of these agents is not fully known. Infected rodents have demonstrated immunomodulation, tumor suppression, clinical disease (particularly in immunodeficient rodents), and histopathology. Perturbations of organismal and cellular physiology also likely occur. These agents posed unique challenges to laboratory animal resource programs once discovered; it was necessary to develop specific diagnostic assays and an understanding of their epidemiology and transmission routes before attempting eradication, and then evaluate eradication methods for efficacy. Even then management approaches varied significantly, from apathy to total exclusion, and such inconsistency has hindered the sharing and transfer of rodents among institutions, particularly for genetically modified rodent models that may not be readily available. As additional infectious agents are discovered in laboratory rodents in coming years, much of what researchers have learned from experiences with the recently identified pathogens will be applicable. This article provides an overview of the discovery, detection, and research impact of infectious agents recently identified in laboratory rodents. We also discuss emerging syndromes for which there is a suspected infectious etiology, and the unique challenges of managing newly emerging infectious agents. PMID:18506061

  12. Improving vaccine trials in infectious disease emergencies.

    PubMed

    Lipsitch, Marc; Eyal, Nir

    2017-07-14

    Unprecedented global effort is under way to facilitate the testing of countermeasures in infectious disease emergencies. Better understanding of the various options for trial design is needed in advance of outbreaks, as is preliminary global agreement on the most suitable designs for the various scenarios. What would enhance the speed, validity, and ethics of clinical studies of such countermeasures? Focusing on studies of vaccine efficacy and effectiveness in emergencies, we highlight three needs: for formal randomized trials-even in most emergencies; for individually randomized trials-even in many emergencies; and for six areas of innovation in trial methodology. These needs should inform current updates of protocols and roadmaps. Copyright © 2017, American Association for the Advancement of Science.

  13. Epidemiological monitoring for emerging infectious diseases

    NASA Astrophysics Data System (ADS)

    Greene, Marjorie

    2010-04-01

    The Homeland Security News Wire has been reporting on new ways to fight epidemics using digital tools such as iPhone, social networks, Wikipedia, and other Internet sites. Instant two-way communication now gives consumers the ability to complement official reports on emerging infectious diseases from health authorities. However, there is increasing concern that these communications networks could open the door to mass panic from unreliable or false reports. There is thus an urgent need to ensure that epidemiological monitoring for emerging infectious diseases gives health authorities the capability to identify, analyze, and report disease outbreaks in as timely and efficient a manner as possible. One of the dilemmas in the global dissemination of information on infectious diseases is the possibility that information overload will create inefficiencies as the volume of Internet-based surveillance information increases. What is needed is a filtering mechanism that will retrieve relevant information for further analysis by epidemiologists, laboratories, and other health organizations so they are not overwhelmed with irrelevant information and will be able to respond quickly. This paper introduces a self-organizing ontology that could be used as a filtering mechanism to increase relevance and allow rapid analysis of disease outbreaks as they evolve in real time.

  14. Investigating and managing the rapid emergence of white-nose syndrome, a novel, fatal, infectious disease of hibernating bats.

    PubMed

    Foley, Janet; Clifford, Deana; Castle, Kevin; Cryan, Paul; Ostfeld, Richard S

    2011-04-01

    White-nose syndrome (WNS) is a fatal disease of bats that hibernate. The etiologic agent of WNS is the fungus Geomyces destructans, which infects the skin and wing membranes. Over 1 million bats in six species in eastern North America have died from WNS since 2006, and as a result several species of bats may become endangered or extinct. Information is lacking on the pathogenesis of G. destructans and WNS, WNS transmission and maintenance, individual and site factors that contribute to the probability of an outbreak of WNS, and spatial dynamics of WNS spread in North America. We considered how descriptive and analytical epidemiology could be used to fill these information gaps, including a four-step (modified) outbreak investigation, application of a set of criteria (Hill's) for assessing causation, compartment models of disease dynamics, and spatial modeling. We cataloged and critiqued adaptive-management options that have been either previously proposed for WNS or were helpful in addressing other emerging diseases of wild animals. These include an ongoing program of prospective surveillance of bats and hibernacula for WNS, treatment of individual bats, increasing population resistance to WNS (through vaccines, immunomodulators, or other methods), improving probability of survival from starvation and dehydration associated with WNS, modifying hibernacula environments to eliminate G. destructans, culling individuals or populations, controlling anthropogenic spread of WNS, conserving genetic diversity of bats, and educating the public about bats and bat conservation issues associated with WNS. Conservation Biology ©2011 Society for Conservation Biology. No claim to original US government works.

  15. Investigating and managing the rapid emergence of white-nose syndrome, a novel, fatal, infectious disease of hibernating bats

    USGS Publications Warehouse

    Foley, Janet; Clifford, Deana; Castle, Kevin; Cryan, Paul M.; Ostfeld, Richard S.

    2011-01-01

    White-nose syndrome (WNS) is a fatal disease of bats that hibernate. The etiologic agent of WNS is the fungus Geomyces destructans, which infects the skin and wing membranes. Over 1 million bats in six species in eastern North America have died from WNS since 2006, and as a result several species of bats may become endangered or extinct. Information is lacking on the pathogenesis of G. destructans and WNS, WNS transmission and maintenance, individual and site factors that contribute to the probability of an outbreak of WNS, and spatial dynamics of WNS spread in North America. We considered how descriptive and analytical epidemiology could be used to fill these information gaps, including a four-step (modified) outbreak investigation, application of a set of criteria (Hill's) for assessing causation, compartment models of disease dynamics, and spatial modeling. We cataloged and critiqued adaptive-management options that have been either previously proposed for WNS or were helpful in addressing other emerging diseases of wild animals. These include an ongoing program of prospective surveillance of bats and hibernacula for WNS, treatment of individual bats, increasing population resistance to WNS (through vaccines, immunomodulators, or other methods), improving probability of survival from starvation and dehydration associated with WNS, modifying hibernacula environments to eliminate G. destructans, culling individuals or populations, controlling anthropogenic spread of WNS, conserving genetic diversity of bats, and educating the public about bats and bat conservation issues associated with WNS.

  16. Hospital preparedness to bioterrorism and other infectious disease emergencies.

    PubMed

    Ippolito, G; Puro, V; Heptonstall, J

    2006-10-01

    In the last 2 decades, successive outbreaks caused by new, newly recognised and resurgent pathogens, and the risk that high-consequence pathogens might be used as bioterrorism agents amply demonstrated the need to enhance capacity in clinical and public health management of highly infectious diseases. In this article we review these recent and current threats to public health, whether naturally occurring or caused by accidental or intentional release. Moreover, we discuss some components of hospital preparedness for, and response to, infectious disease of the emergencies in developed countries. The issues of clinical awareness and education, initial investigation and management, surge capacity, communication, and caring for staff and others affected by the emergency are discussed. We also emphasise the importance of improving the everyday practice of infection control by healthcare professionals.

  17. Emerging infectious diseases: a cause for concern.

    PubMed

    Berns, D S; Rager, B

    2000-12-01

    As the twenty-first century begins it becomes increasingly apparent that the twentieth century, which opened with the promise of the eradication of most infectious diseases, closed with the specter of the reemergence of many deadly infectious diseases that have a rapidly increasing incidence and geographic range. Equally if not more alarming is the appearance of new infectious diseases that have become major sources of morbidity and mortality. Among recent examples are HIV/AIDS, hantavirus pulmonary syndrome, Lyme disease, hemolytic uremic syndrome (caused by a strain of Escherichia coli), Rift Valley fever, Dengue hemorrhagic fever, malaria, cryptosporidiosis, and schistosomiasis. The reasons for this situation are easily identified in some cases as associated with treatment modalities (permissive use of antibiotics), the industrial use of antibiotics, demographic changes, societal behavior patterns, changes in ecology, global warming, the inability to deliver minimal health care and the neglect of well-established public health priorities. In addition is the emergence of diseases of another type. We have begun to characterize the potential microbial etiology of what has historically been referred to as chronic diseases.

  18. Factors in the emergence of infectious diseases.

    PubMed Central

    Morse, S. S.

    1995-01-01

    "Emerging" infectious diseases can be defined as infections that have newly appeared in a population or have existed but are rapidly increasing in incidence or geographic range. Among recent examples are HIV/AIDS, hantavirus pulmonary syndrome, Lyme disease, and hemolytic uremic syndrome (a foodborne infection caused by certain strains of Escherichia coli). Specific factors precipitating disease emergence can be identified in virtually all cases. These include ecological, environmental, or demographic factors that place people at increased contact with a previously unfamiliar microbe or its natural host or promote dissemination. These factors are increasing in prevalence; this increase, together with the ongoing evolution of viral and microbial variants and selection for drug resistance, suggests that infections will continue to emerge and probably increase and emphasizes the urgent need for effective surveillance and control. Dr. David Satcher's article and this overview inaugurate Perspectives, a regular section in this journal intended to present and develop unifying concepts and strategies for considering emerging infections and their underlying factors. The editors welcome, as contributions to the Perspectives section, overviews, syntheses, and case studies that shed light on how and why infections emerge, and how they may be anticipated and prevented. PMID:8903148

  19. Managed care and the infectious diseases specialist.

    PubMed

    Tice, A D; Slama, T G; Berman, S; Braun, P; Burke, J P; Cherney, A; Gross, P A; Harris, P; Reid-Hatton, M; Hoffman, R; Joseph, P; Lawton, S; Massanari, R M; Miller, Z I; Osheroff, W J; Poretz, D; Shalowitz, M; Simmons, B; Turner, J P; Wade, B; Nolet, B R

    1996-08-01

    There is growing demand to contain health care costs and to reassess the value of medical services. The traditional hospital, academic, and research roles of the infectious disease (ID) specialist are threatened, yet there is an increasing need for expertise because of growing antimicrobial resistance and emerging pathogens. Opportunities exist to develop and expand services for the care of patients infected with human immunodeficiency virus and in infection control, epidemiology, outcomes research, outpatient intravenous therapy, and resource management. It is important for ID physicians to appreciate the principles involved in managed care and the areas in which ID services can be valuable. To be effective, physicians need to know about tools such as practice guidelines, physician profiling, outcomes monitoring, computerized information management, risk sharing, networking, and marketing, as well as related legal issues. With a positive attitude toward learning, application, and leadership, ID physicians can redefine their role and expand their services through managed care.

  20. Vaccine development for emerging virulent infectious diseases.

    PubMed

    Maslow, Joel N

    2017-10-04

    The recent outbreak of Zaire Ebola virus in West Africa altered the classical paradigm of vaccine development and that for emerging infectious diseases (EIDs) in general. In this paper, the precepts of vaccine discovery and advancement through pre-clinical and clinical assessment are discussed in the context of the recent Ebola virus, Middle East Respiratory Syndrome coronavirus (MERS-CoV), and Zika virus outbreaks. Clinical trial design for diseases with high mortality rates and/or high morbidity in the face of a global perception of immediate need and the factors that drive design in the face of a changing epidemiology are presented. Vaccines for EIDs thus present a unique paradigm to standard development precepts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Emerging infectious diseases and travel medicine.

    PubMed

    Ostroff, S M; Kozarsky, P

    1998-03-01

    International movement of individuals, populations, and products is one of the major factors associated with the emergence and reemergence of infectious diseases as the pace of global travel and commerce increases rapidly. Travel can be associated with disease emergence because (1) the disease arises in an area of heavy tourism, (2) tourists may be at heightened risk because of their activities, or (3) because they can act as vectors to transport the agent to new areas. Examples of recently recognized diseases with relationship to travel include HIV, Legionnaire's disease, cyclosporiasis, Vibrio cholerae O139 Bengal, hantavirus, and variant Creutzfeldt-Jacob disease. Reemerging diseases include dengue fever, malaria, cholera, schistosomiasis, leptospirosis, and viral hemorrhagic fevers. In addition, tuberculosis, drug-resistant shigellosis, and cholera have been major concerns in refugee and migrant populations. Because of the unique role of travel in emerging infections, efforts are underway to address this factor by agencies such as the CDC, WHO, the International Society of Travel Medicine, and the travel industry.

  2. The Bug Stops Here: Force Protection and Emerging Infectious Diseases

    DTIC Science & Technology

    2005-11-01

    The Bug Stops Here Force Protection and Emerging Infectious Diseases Donald F. Thompson, Joel...2005 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE The Bug Stops Here: Force Protection and Emerging Infectious Diseases 5a...Anthony J. McMichael, “ Social and Environmental Risk Factors in the Emergence of Infectious Diseases,” Nature Medicine, December 2004, vol. 10, no. 12

  3. Infectious waste management and laboratory design criteria.

    PubMed

    Zaki, A N; Campbell, J R

    1997-11-01

    Infectious waste management and laboratory design criteria are provided to help in recognizing what information needs to be included in an individual program and to develop an infectious waste management plan. Relevant engineering aspects of a containment laboratory are described in detail, and suggested equipment and operating procedures for collection, sterilization, and disposal of solid and liquid waste are discussed. The need for public awareness regarding infectious waste is discussed, including liability considerations associated with improper disposal. This study shows how proper management of infectious waste results in lower disposal cost, lower operating costs, reduction in liabilities, increased worker safety, and a cleaner environment.

  4. Eco-social processes influencing infectious disease emergence and spread.

    PubMed

    Jones, Bryony A; Betson, Martha; Pfeiffer, Dirk U

    2017-01-01

    The complexity and connectedness of eco-social processes have major influence on the emergence and spread of infectious diseases amongst humans and animals. The disciplinary nature of most research activity has made it difficult to improve our understanding of interactions and feedback loops within the relevant systems. Influenced by the One Health approach, increasing efforts have recently been made to address this knowledge gap. Disease emergence and spread is strongly influenced by host density and contact structures, pathogen characteristics and pathogen population and molecular evolutionary dynamics in different host species, and host response to infection. All these mechanisms are strongly influenced by eco-social processes, such as globalization and urbanization, which lead to changes in global ecosystem dynamics, including patterns of mobility, human population density and contact structures, and food production and consumption. An improved understanding of epidemiological and eco-social processes, including their interdependence, will be essential to be able to manage diseases in these circumstances. The interfaces between wild animals, domestic animals and humans need to be examined to identify the main risk pathways and put in place appropriate mitigation. Some recent examples of emerging infectious disease are described to illustrate eco-social processes that are influencing disease emergence and spread.

  5. Infectious Mononucleosis: Recognition and Management in Athletes.

    ERIC Educational Resources Information Center

    Eichner, Edward R.

    1987-01-01

    Infectious mononucleosis strikes many young athletes. Considered here are its epidemiology, pathophysiology, diagnosis, natural course, complications, and management. The focus is on concerns of athletes with a perspective on personality, convalescence, and chronic fatigue. (Author/MT)

  6. A comprehensive infectious disease management system.

    PubMed

    Marcu, Alex; Farley, John D

    2009-01-01

    An efficient electronic management system is now an essential tool for the successful management and monitoring of those affected by communicable infectious diseases (Human Immunodeficiency Virus - HIV, hepatitis C - HEP C) during the course of the treatment. The current methods which depend heavily on manual collecting, compiling and disseminating treatment information are labor-intensive and time consuming. Clinics specialized in the treatment of infectious diseases use a mix of electronic systems that fail to interact with each other, result in data duplication, and do not support treatment of the patient as a whole. The purpose of the Infectious Disease Management System is to reduce the administrative overhead associated with data collection and analysis while providing correlation abilities and decision support in accordance with defined treatment guidelines. This Infectious Disease Management System was developed to: Ensure cost effectiveness by means of low software licensing costs, Introduce a centralized mechanism of collecting and monitoring all infectious disease management data, Automate electronic retrieval of laboratory findings, Introduce a decision support mechanism as per treatment guidelines, Seamlessly integrate of application modules, Provide comprehensive reporting capabilities, Maintain a high level of user friendliness.

  7. Perspectives of public health laboratories in emerging infectious diseases.

    PubMed

    Chua, Kaw Bing; Gubler, Duane J

    2013-06-01

    The world has experienced an increased incidence and transboundary spread of emerging infectious diseases over the last four decades. We divided emerging infectious diseases into four categories, with subcategories in categories 1 and 4. The categorization was based on the nature and characteristics of pathogens or infectious agents causing the emerging infections, which are directly related to the mechanisms and patterns of infectious disease emergence. The factors or combinations of factors contributing to the emergence of these pathogens vary within each category. We also classified public health laboratories into three types based on function, namely, research, reference and analytical diagnostic laboratories, with the last category being subclassified into primary (community-based) public health and clinical (medical) analytical diagnostic laboratories. The frontline/leading and/or supportive roles to be adopted by each type of public health laboratory for optimal performance to establish the correct etiological agents causing the diseases or outbreaks vary with respect to each category of emerging infectious diseases. We emphasize the need, especially for an outbreak investigation, to establish a harmonized and coordinated national public health laboratory system that integrates different categories of public health laboratories within a country and that is closely linked to the national public health delivery system and regional and international high-end laboratories.

  8. Perspectives of public health laboratories in emerging infectious diseases

    PubMed Central

    Chua, Kaw Bing; Gubler, Duane J

    2013-01-01

    The world has experienced an increased incidence and transboundary spread of emerging infectious diseases over the last four decades. We divided emerging infectious diseases into four categories, with subcategories in categories 1 and 4. The categorization was based on the nature and characteristics of pathogens or infectious agents causing the emerging infections, which are directly related to the mechanisms and patterns of infectious disease emergence. The factors or combinations of factors contributing to the emergence of these pathogens vary within each category. We also classified public health laboratories into three types based on function, namely, research, reference and analytical diagnostic laboratories, with the last category being subclassified into primary (community-based) public health and clinical (medical) analytical diagnostic laboratories. The frontline/leading and/or supportive roles to be adopted by each type of public health laboratory for optimal performance to establish the correct etiological agents causing the diseases or outbreaks vary with respect to each category of emerging infectious diseases. We emphasize the need, especially for an outbreak investigation, to establish a harmonized and coordinated national public health laboratory system that integrates different categories of public health laboratories within a country and that is closely linked to the national public health delivery system and regional and international high-end laboratories. PMID:26038473

  9. 75 FR 22817 - Emerging Infectious Diseases: Evaluation to Implementation for Transfusion and Transplantation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    ... HUMAN SERVICES Food and Drug Administration Emerging Infectious Diseases: Evaluation to Implementation... Infectious Diseases: Evaluation to Implementation for Transfusion and Transplantation Safety'' (EID public... of risk from, and prioritization of response to, emerging infectious diseases relevant to blood...

  10. New technologies in predicting, preventing and controlling emerging infectious diseases

    PubMed Central

    Christaki, Eirini

    2015-01-01

    Surveillance of emerging infectious diseases is vital for the early identification of public health threats. Emergence of novel infections is linked to human factors such as population density, travel and trade and ecological factors like climate change and agricultural practices. A wealth of new technologies is becoming increasingly available for the rapid molecular identification of pathogens but also for the more accurate monitoring of infectious disease activity. Web-based surveillance tools and epidemic intelligence methods, used by all major public health institutions, are intended to facilitate risk assessment and timely outbreak detection. In this review, we present new methods for regional and global infectious disease surveillance and advances in epidemic modeling aimed to predict and prevent future infectious diseases threats. PMID:26068569

  11. New technologies in predicting, preventing and controlling emerging infectious diseases.

    PubMed

    Christaki, Eirini

    2015-01-01

    Surveillance of emerging infectious diseases is vital for the early identification of public health threats. Emergence of novel infections is linked to human factors such as population density, travel and trade and ecological factors like climate change and agricultural practices. A wealth of new technologies is becoming increasingly available for the rapid molecular identification of pathogens but also for the more accurate monitoring of infectious disease activity. Web-based surveillance tools and epidemic intelligence methods, used by all major public health institutions, are intended to facilitate risk assessment and timely outbreak detection. In this review, we present new methods for regional and global infectious disease surveillance and advances in epidemic modeling aimed to predict and prevent future infectious diseases threats.

  12. Personalized Medicine and Infectious Disease Management.

    PubMed

    Jensen, Slade O; van Hal, Sebastiaan J

    2017-09-29

    A recent study identified pathogen factors associated with an increased mortality risk in Staphylococcus aureus bacteremia, using predictive modelling and a combination of genotypic, phenotypic, and clinical data. This study conceptually validates the benefit of personalized medicine and highlights the potential use of whole genome sequencing in infectious disease management. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Waiting time to infectious disease emergence

    PubMed Central

    2016-01-01

    Emerging diseases must make a transition from stuttering chains of transmission to sustained chains of transmission, but this critical transition need not coincide with the system becoming supercritical. That is, the introduction of infection to a supercritical system results in a significant fraction of the population becoming infected only with a certain probability. Understanding the waiting time to the first major outbreak of an emerging disease is then more complicated than determining when the system becomes supercritical. We treat emergence as a dynamic bifurcation, and use the concept of bifurcation delay to understand the time to emergence after a system becomes supercritical. Specifically, we consider an SIR model with a time-varying transmission term and random infections originating from outside the population. We derive an analytic density function for the delay times and find it to be, in general, in agreement with stochastic simulations. We find the key parameters to be the rate of introduction of infection and the rate of change of the basic reproductive ratio. These findings aid our understanding of real emergence events, and can be incorporated into early-warning systems aimed at forecasting disease risk. PMID:27798277

  14. Emerging Infectious Diseases, Animals, and Future Epidemics.

    PubMed

    DuPont, Herbert L

    2017-02-01

    Emerging and reemerging infections have become prevalent in the United States since the 1970s, causing illness, death, and fear among the public. The published literature was reviewed to offer a perspective on risk factors for disease acquisition and to allow a prediction of the next microbial assault after Ebola and Zika. Four well-integrated factors likely will contribute simultaneously: animals colonized or infected by pathogens capable of human transmission, microbes recurrently changing their virulence, a growing number of susceptible people, and climatic and environmental factors encouraging disease transmission. The next pathogen likely to emerge in an important way in the United States is a new mutant virus arising from a well-established RNA virus family. Standard public health principles, including monitoring general populations for disease, developing new reagents as pathogens arise, implementing control efforts such as effective antibiotic stewardship programs, and vaccine development and administration will minimize damage from the emerging organisms.

  15. Bats, emerging infectious diseases, and the rabies paradigm revisited

    PubMed Central

    Kuzmin, Ivan V.; Bozick, Brooke; Guagliardo, Sarah A.; Kunkel, Rebekah; Shak, Joshua R.; Tong, Suxiang; Rupprecht, Charles E

    2011-01-01

    The significance of bats as sources of emerging infectious diseases has been increasingly appreciated, and new data have been accumulated rapidly during recent years. For some emerging pathogens the bat origin has been confirmed (such as lyssaviruses, henipaviruses, coronaviruses), for other it has been suggested (filoviruses). Several recently identified viruses remain to be ‘orphan’ but have a potential for further emergence (such as Tioman, Menangle, and Pulau viruses). In the present review we summarize information on major bat-associated emerging infections and discuss specific characteristics of bats as carriers of pathogens (from evolutionary, ecological, and immunological positions). We also discuss drivers and forces of an infectious disease emergence and describe various existing and potential approaches for control and prevention of such infections at individual, populational, and societal levels. PMID:24149032

  16. Federal Emergency Management Agency

    MedlinePlus

    ... Updates Emergency Management Agencies Emergency Management Institute El Niño Environmental Planning and Historic Preservation Program Exercise Fact ... Local, State, Tribal and Non-Profit Recovery Resources Region I Region II Region III Region IV Region ...

  17. Emerging infectious diseases in southeast Asia: regional challenges to control.

    PubMed

    Coker, Richard J; Hunter, Benjamin M; Rudge, James W; Liverani, Marco; Hanvoravongchai, Piya

    2011-02-12

    Southeast Asia is a hotspot for emerging infectious diseases, including those with pandemic potential. Emerging infectious diseases have exacted heavy public health and economic tolls. Severe acute respiratory syndrome rapidly decimated the region's tourist industry. Influenza A H5N1 has had a profound effect on the poultry industry. The reasons why southeast Asia is at risk from emerging infectious diseases are complex. The region is home to dynamic systems in which biological, social, ecological, and technological processes interconnect in ways that enable microbes to exploit new ecological niches. These processes include population growth and movement, urbanisation, changes in food production, agriculture and land use, water and sanitation, and the effect of health systems through generation of drug resistance. Southeast Asia is home to about 600 million people residing in countries as diverse as Singapore, a city state with a gross domestic product (GDP) of US$37,500 per head, and Laos, until recently an overwhelmingly rural economy, with a GDP of US$890 per head. The regional challenges in control of emerging infectious diseases are formidable and range from influencing the factors that drive disease emergence, to making surveillance systems fit for purpose, and ensuring that regional governance mechanisms work effectively to improve control interventions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Recurrence and emergence of infectious diseases in Djibouti city.

    PubMed

    Rodier, G R; Parra, J P; Kamil, M; Chakib, S O; Cope, S E

    1995-01-01

    Public health authorities are now increasingly concerned by changes in the epidemiology of infectious diseases which may have an adverse impact on their budget plans and control strategies. Rapid increases in population and urban migration, various ecological changes, increasing poverty, and a rise in international travel have contributed to the worldwide vulnerability of human populations to the emergence, recurrence or spread of infectious diseases. In the rapidly growing city of Djibouti in East Africa, public health priorities have been altered during the last 10 years by diseases which were unknown or under control until the early 1980s. These diseases, including malaria, AIDS, tuberculosis, dengue fever and cholera, are consuming considerable resources. This article on Djibouti illustrates the epidemiological changes in the region. Besides the specific ecological and behavioural changes, which accompany rapid population growth, poverty seems to be a major cause for the emergence and recurrence of infectious diseases.

  19. Recurrence and emergence of infectious diseases in Djibouti city.

    PubMed Central

    Rodier, G. R.; Parra, J. P.; Kamil, M.; Chakib, S. O.; Cope, S. E.

    1995-01-01

    Public health authorities are now increasingly concerned by changes in the epidemiology of infectious diseases which may have an adverse impact on their budget plans and control strategies. Rapid increases in population and urban migration, various ecological changes, increasing poverty, and a rise in international travel have contributed to the worldwide vulnerability of human populations to the emergence, recurrence or spread of infectious diseases. In the rapidly growing city of Djibouti in East Africa, public health priorities have been altered during the last 10 years by diseases which were unknown or under control until the early 1980s. These diseases, including malaria, AIDS, tuberculosis, dengue fever and cholera, are consuming considerable resources. This article on Djibouti illustrates the epidemiological changes in the region. Besides the specific ecological and behavioural changes, which accompany rapid population growth, poverty seems to be a major cause for the emergence and recurrence of infectious diseases. PMID:8907768

  20. Strongyloidiasis: An Emerging Infectious Disease in China

    PubMed Central

    Wang, Chunmei; Xu, Jiabao; Zhou, Xiaohong; Li, Juan; Yan, Guiyun; James, Anthony A.; Chen, Xiaoguang

    2013-01-01

    Since the first case of strongyloidiasis reported in China in 1973, there have been 330 confirmed cases as of 2011. The present study conducted a meta-analysis on 106 cases for which detailed information on clinical symptoms, diagnosis, and outcome was available. Most (63%) cases were from the past decade. Immunocompromised patients and those given cortical hormones accounted for 68% of the cases, and case-fatality rate was 38%. General clinical symptoms included abdominal pain (53%), diarrhea (46%), fever (40%), and vomiting (39%). The parasite positivity rate in feces, sputum, and urine by microscopic diagnosis was 75%, 24%, and 8%, respectively, and gastrointestinal endoscopy or other biopsy detection rates were 17%. A lack of specific clinical manifestations makes early diagnosis and correct treatment difficult. Strongyloidiasis is an emerging disease in China, and public and clinical awareness needs to be raised to improve prevention and control. PMID:23468357

  1. Internet-based surveillance systems for monitoring emerging infectious diseases.

    PubMed

    Milinovich, Gabriel J; Williams, Gail M; Clements, Archie C A; Hu, Wenbiao

    2014-02-01

    Emerging infectious diseases present a complex challenge to public health officials and governments; these challenges have been compounded by rapidly shifting patterns of human behaviour and globalisation. The increase in emerging infectious diseases has led to calls for new technologies and approaches for detection, tracking, reporting, and response. Internet-based surveillance systems offer a novel and developing means of monitoring conditions of public health concern, including emerging infectious diseases. We review studies that have exploited internet use and search trends to monitor two such diseases: influenza and dengue. Internet-based surveillance systems have good congruence with traditional surveillance approaches. Additionally, internet-based approaches are logistically and economically appealing. However, they do not have the capacity to replace traditional surveillance systems; they should not be viewed as an alternative, but rather an extension. Future research should focus on using data generated through internet-based surveillance and response systems to bolster the capacity of traditional surveillance systems for emerging infectious diseases. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Landscape epidemiology of emerging infectious diseases in natural and human-altered ecosystems

    Treesearch

    Ross K. Meentemeyer; Sarah E. Haas; Tomas. Vaclavik

    2012-01-01

    A central challenge to studying emerging infectious diseases (EIDs) is a landscape dilemma: Our best empirical understanding of disease dynamics occurs at local scales, whereas pathogen invasions and management occur over broad spatial extents. The burgeoning field of landscape epidemiology integrates concepts and approaches from disease ecology with the...

  3. Landscape epidemiology of emerging infectious diseases in natural and human-altered ecosystems

    Treesearch

    Ross K. Meentemeyer; Sarah Haas; Tomáš Václavík

    2013-01-01

    A central challenge to studying emerging infectious diseases (EIDs) is a landscape dilemma: our best empirical understanding of disease dynamics occurs at local scales while pathogen invasions and management occur over broad spatial extents. The burgeoning field of landscape epidemiology integrates concepts and approaches from disease ecology with the macro-scale lens...

  4. Emerging and reemerging infectious diseases: the perpetual challenge.

    PubMed

    Fauci, Anthony S

    2005-12-01

    Public health officials once suggested that it might someday be possible to "close the book" on the study and treatment of infectious diseases. However, it is now clear that endemic diseases as well as newly emerging ones (e.g., severe acute respiratory syndrome [SARS]), reemerging ones (e.g., West Nile virus), and even deliberately disseminated infectious diseases (e.g., anthrax from bioterrorism) continue to pose a substantial threat throughout the world. Over the past several decades, the global effort to identify and characterize infectious agents, decipher the underlying pathways by which they cause disease, and develop preventive measures and treatments for many of the world's most dangerous pathogens has helped control many endemic diseases. But despite considerable progress, infectious diseases continue to present significant challenges as new microbial threats emerge and reemerge. HIV/AIDS, malaria, tuberculosis, influenza, SARS, West Nile virus, Marburg virus, and bioterrorism are examples of some of the emerging and reemerging threats. In responding to these ongoing challenges, a new paradigm in countermeasure development is needed. In the past, U.S. government-sponsored biomedical researchers have focused on basic research and concept development, leaving product development to the pharmaceutical industry. Increasingly, however, the government has become involved in more targeted countermeasure development efforts. In this regard, partnerships between government, industry, and academia are necessary as we struggle to maintain and update our armamentarium in the struggle to outwit the microbes that pose a never-ending threat to mankind.

  5. From Expert Protocols to Standardized Management of Infectious Diseases.

    PubMed

    Lagier, Jean-Christophe; Aubry, Camille; Delord, Marion; Michelet, Pierre; Tissot-Dupont, Hervé; Million, Matthieu; Brouqui, Philippe; Raoult, Didier; Parola, Philippe

    2017-08-15

    We report here 4 examples of management of infectious diseases (IDs) at the University Hospital Institute Méditerranée Infection in Marseille, France, to illustrate the value of expert protocols feeding standardized management of IDs. First, we describe our experience on Q fever and Tropheryma whipplei infection management based on in vitro data and clinical outcome. Second, we describe our management-based approach for the treatment of infective endocarditis, leading to a strong reduction of mortality rate. Third, we report our use of fecal microbiota transplantation to face severe Clostridium difficile infections and to perform decolonization of patients colonized by emerging highly resistant bacteria. Finally, we present the standardized management of the main acute infections in patients admitted in the emergency department, promoting antibiotics by oral route, checking compliance with the protocol, and avoiding the unnecessary use of intravenous and urinary tract catheters. Overall, the standardization of the management is the keystone to reduce both mortality and morbidity related to IDs. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  6. Forecasting infectious disease emergence subject to seasonal forcing.

    PubMed

    Miller, Paige B; O'Dea, Eamon B; Rohani, Pejman; Drake, John M

    2017-09-06

    Despite high vaccination coverage, many childhood infections pose a growing threat to human populations. Accurate disease forecasting would be of tremendous value to public health. Forecasting disease emergence using early warning signals (EWS) is possible in non-seasonal models of infectious diseases. Here, we assessed whether EWS also anticipate disease emergence in seasonal models. We simulated the dynamics of an immunizing infectious pathogen approaching the tipping point to disease endemicity. To explore the effect of seasonality on the reliability of early warning statistics, we varied the amplitude of fluctuations around the average transmission. We proposed and analyzed two new early warning signals based on the wavelet spectrum. We measured the reliability of the early warning signals depending on the strength of their trend preceding the tipping point and then calculated the Area Under the Curve (AUC) statistic. Early warning signals were reliable when disease transmission was subject to seasonal forcing. Wavelet-based early warning signals were as reliable as other conventional early warning signals. We found that removing seasonal trends, prior to analysis, did not improve early warning statistics uniformly. Early warning signals anticipate the onset of critical transitions for infectious diseases which are subject to seasonal forcing. Wavelet-based early warning statistics can also be used to forecast infectious disease.

  7. Validity of International Health Regulations in reporting emerging infectious diseases.

    PubMed

    Edelstein, Michael; Heymann, David L; Giesecke, Johan; Weinberg, Julius

    2012-07-01

    Understanding which emerging infectious diseases are of international public health concern is vital. The International Health Regulations include a decision instrument to help countries determine which public health events are of international concern and require reporting to the World Health Organization (WHO) on the basis of seriousness, unusualness, international spread and trade, or need for travel restrictions. This study examined the validity of the International Health Regulations decision instrument in reporting emerging infectious disease to WHO by calculating its sensitivity, specificity, and positive predictive value. It found a sensitivity of 95.6%, a specificity of 38%, and a positive predictive value of 35.5%. These findings are acceptable if the notification volume to WHO remains low. Validity could be improved by setting more prescriptive criteria of seriousness and unusualness and training persons responsible for notification. However, the criteria should be balanced with the need for the instrument to adapt to future unknown threats.

  8. Management of infectious complications in percutaneous nephrolithotomy.

    PubMed

    Negrete-Pulido, Oscar; Gutierrez-Aceves, Jorge

    2009-10-01

    Infectious complications are one of the most frequent and feared adverse medical events in percutaneous nephrolithotomy. They represent a dangerous and life-threatening condition, especially when postoperative septicemia or severe sepsis develops. In order to limit morbidity and mortality it is crucial to recognize preoperative and intraoperative risk factors that could be clear contributors to an adverse infectious event; those factors are mainly immunosuppression caused by some comorbidities, presence of urinary infection or colonization, stone characteristics, obstruction, long-lasting operation, and high intrapelvic pressure during nephrolithotomy. Close observation during the immediate and early postoperative period must be established and a high index of suspicion must be maintained to identify a major complication. The early recognition and prompt multidisciplinary management of sepsis is mandatory to optimize the final outcome. Appropriate therapy is a continuum of management of infection, ranging from adequate drainage and broad-spectrum antibiotics to aggressive fluid resuscitation and invasive monitoring with medical management in the intensive care setting until the causative agent is found and eradicated.

  9. Infectious intracranial aneurysms: triage and management.

    PubMed

    Gulek, Bernice G; Rapport, Richard

    2011-02-01

    Infectious intracranial aneurysms are a rare but serious potential complication of subacute endocarditis. Early diagnosis and treatment is essential to prevent devastating neurological deficits and mortality. Because nurse practitioners' roles expand into acute care as well as urgent care settings, they are frequently involved in the care of this population. Identifying the patients at risk, ordering appropriate studies, and initiating goal directed therapy are vital to outcomes. For nurse practitioners who are involved in care of neuroscience populations, it is important to be familiar with disease processes. This article provides a literature review of the topic, explores diagnostic methods, discusses management strategies, and presents an illustrative case.

  10. Multinational corporations and infectious disease: Embracing human rights management techniques.

    PubMed

    Salcito, Kendyl; Singer, Burton H; Weiss, Mitchell G; Winkler, Mirko S; Krieger, Gary R; Wielga, Mark; Utzinger, Jürg

    2014-01-01

    Global health institutions have called for governments, international organisations and health practitioners to employ a human rights-based approach to infectious diseases. The motivation for a human rights approach is clear: poverty and inequality create conditions for infectious diseases to thrive, and the diseases, in turn, interact with social-ecological systems to promulgate poverty, inequity and indignity. Governments and intergovernmental organisations should be concerned with the control and elimination of these diseases, as widespread infections delay economic growth and contribute to higher healthcare costs and slower processes for realising universal human rights. These social determinants and economic outcomes associated with infectious diseases should interest multinational companies, partly because they have bearing on corporate productivity and, increasingly, because new global norms impose on companies a responsibility to respect human rights, including the right to health. We reviewed historical and recent developments at the interface of infectious diseases, human rights and multinational corporations. Our investigation was supplemented with field-level insights at corporate capital projects that were developed in areas of high endemicity of infectious diseases, which embraced rights-based disease control strategies. Experience and literature provide a longstanding business case and an emerging social responsibility case for corporations to apply a human rights approach to health programmes at global operations. Indeed, in an increasingly globalised and interconnected world, multinational corporations have an interest, and an important role to play, in advancing rights-based control strategies for infectious diseases. There are new opportunities for governments and international health agencies to enlist corporate business actors in disease control and elimination strategies. Guidance offered by the United Nations in 2011 that is widely embraced

  11. Emergency Management Guide

    SciTech Connect

    Not Available

    1994-09-01

    This Emergency Management Guide provides guidance for the implementation of the requirements of the Department of Energy (DOE) Emergency Management System (EMS). The DOE EMS is established by DOE 5500.1B, EMERGENCY DEPARTMENT SYSTEM. The provisions of this guide specify neither policy nor responsibilities. It provides an acceptable approach to emergency planning activities at DOE facilities and sites. Other approaches may be used provided that they are approved by the cognizant Program Secretarial Officer (PSO), with the concurrence of the Director of Emergency Operations (DEO).

  12. Management of Chronic Infectious Diseases in School Children.

    ERIC Educational Resources Information Center

    Illinois State Board of Education, Springfield.

    This document contains guidelines for developing policies and procedures related to chronic infectious diseases, as recommended by the Illinois Task Force on School Management of Infectious Disease. It is designed to help school personnel understand how infectious diseases can be transmitted, and to assist school districts in the development and…

  13. Emerging and Re-Emerging Infectious Diseases. Grades 9-12. NIH Curriculum Supplement Series.

    ERIC Educational Resources Information Center

    Biological Sciences Curriculum Study, Colorado Springs.

    This curriculum supplement guide brings the latest medical discoveries to classrooms. This module focuses on the objectives of introducing students to major concepts related to emerging and re-emerging infectious diseases, and developing an understanding of the relationship between biomedical research and personal and public health. This module…

  14. The landscape genetics of infectious disease emergence and spread

    PubMed Central

    Biek, Roman; Real, Leslie A.

    2011-01-01

    The spread of parasites is inherently a spatial process often embedded in physically complex landscapes. It is therefore not surprising that infectious disease researchers are increasingly taking a landscape genetics perspective to elucidate mechanisms underlying basic ecological processes driving infectious disease dynamics and to understand the linkage between spatially-dependent population processes and the geographic distribution of genetic variation within both hosts and parasites. The increasing availability of genetic information on hosts and parasites when coupled to their ecological interactions can lead to insights for predicting patterns of disease emergence, spread, and control. Here, we review research progress in this area based on four different motivations for the application of landscape genetics approaches: (1) assessing the spatial organization of genetic variation in parasites as a function of environmental variability, (2) using host population genetic structure as a means to parameterize ecological dynamics that indirectly influence parasite populations, e.g. gene flow and movement pathways across heterogeneous landscapes and the concurrent transport of infectious agents, (3) elucidating the temporal and spatial scales of disease processes, and (4) reconstructing and understanding infectious disease invasion. Throughout this review, we emphasise that landscape genetic principles are relevant to infection dynamics across a range of scales from within host dynamics to global geographic patterns and that they can also be applied to unconventional “landscapes” such as heterogeneous contact networks underlying the spread of human and livestock diseases. We conclude by discussing some general considerations and problems for inferring epidemiological processes from genetic data and try to identify possible future directions and applications for this rapidly expanding field. PMID:20618897

  15. A Learner-led, Discussion-based Elective on Emerging Infectious Disease

    PubMed Central

    2015-01-01

    Objective. To implement a learner-led, discussion-based course aimed at exposing second-year pharmacy learners to the study of emerging infectious diseases from a global health perspective and to assess the role and importance of pharmacists in the management of disease outbreaks. Design. Learners examined literature pertinent to an emerging infectious disease in a 3-credit, discussion-based course and participated in peer discussion led by a designated learner. Instructional materials included journal articles, audio-visual presentations, documentaries, book chapters, movies, newspaper/magazine articles, and other materials. Learning outcomes were measured based on the ability of learners to perform critical thinking and analysis, communicate with their peers, and participate in class discussions. Assessment. The course was offered to 2 consecutive cohorts consisting of 14 and 16 learners, respectively. Overall, every learner in the first cohort achieved a final grade of A for the course. In the second cohort, the overall grade distribution consisted of grades of A, B, and C for the course. Learner evaluations indicated that the active-learning, discussion-based environment significantly enhanced interest in the topic and overall performance in the course. Conclusion. The elective course on emerging infectious diseases provided in-depth exposure to disease topics normally not encountered in the pharmacy curriculum. Learners found the material and format valuable, and the course enhanced their appreciation of infectious diseases, research methodology, critical thinking and analysis, and their roles as pharmacists. PMID:26430268

  16. A Learner-led, Discussion-based Elective on Emerging Infectious Disease.

    PubMed

    Mathias, Clinton

    2015-08-25

    Objective. To implement a learner-led, discussion-based course aimed at exposing second-year pharmacy learners to the study of emerging infectious diseases from a global health perspective and to assess the role and importance of pharmacists in the management of disease outbreaks. Design. Learners examined literature pertinent to an emerging infectious disease in a 3-credit, discussion-based course and participated in peer discussion led by a designated learner. Instructional materials included journal articles, audio-visual presentations, documentaries, book chapters, movies, newspaper/magazine articles, and other materials. Learning outcomes were measured based on the ability of learners to perform critical thinking and analysis, communicate with their peers, and participate in class discussions. Assessment. The course was offered to 2 consecutive cohorts consisting of 14 and 16 learners, respectively. Overall, every learner in the first cohort achieved a final grade of A for the course. In the second cohort, the overall grade distribution consisted of grades of A, B, and C for the course. Learner evaluations indicated that the active-learning, discussion-based environment significantly enhanced interest in the topic and overall performance in the course. Conclusion. The elective course on emerging infectious diseases provided in-depth exposure to disease topics normally not encountered in the pharmacy curriculum. Learners found the material and format valuable, and the course enhanced their appreciation of infectious diseases, research methodology, critical thinking and analysis, and their roles as pharmacists.

  17. Public apprehension of emerging infectious diseases: are changes afoot?

    PubMed

    Joffe, Helene

    2011-07-01

    Using social representations theory this paper casts light on the pattern of content that characterises the public response to emerging and re-emerging infectious diseases (EID). The pattern is: distancing the disease from the self/ one's in-groups; blame of particular entities for the disease's origin and/or spread; and stigmatisation of those who have contracted it and/or who are represented as having intensified its spread. This pattern is not unique to EID but extends to many risks, making EID fruitful events for understanding public apprehension of potential dangers. This process may be driven by worry, fear and anxiety since when levels of these are low, as has arguably been the case with the 2009/10 "Swine Flu" pandemic, the pattern transforms. The distancing-blame-stigma pattern may also be transformed by growing reflexivity, a feature of late modern societies, as well as material features of the epidemic and "EID fatigue".

  18. Emergency Management of Myasthenia Gravis

    MedlinePlus

    ... to weakened throat muscles and accumulated secretions. EMERGENCY MANAGEMENT OF MG The MGFA mission is to facilitate ... fax mgfa@myasthenia.org • www.myasthenia.org EMERGENCY MANAGEMENT OF MG Emergency Management Important information for the ...

  19. The Infectious Diseases Society of America emerging infections network: bridging the gap between clinical infectious diseases and public health.

    PubMed

    Pillai, Satish K; Beekmann, Susan E; Santibanez, Scott; Polgreen, Philip M

    2014-04-01

    In 1995, the Centers for Disease Control and Prevention granted a Cooperative Agreement Program award to the Infectious Diseases Society of America to develop a provider-based emerging infections sentinel network, the Emerging Infections Network (EIN). Over the past 17 years, the EIN has evolved into a flexible, nationwide network with membership representing a broad cross-section of infectious disease physicians. The EIN has an active electronic mail conference (listserv) that facilitates communication among infectious disease providers and the public health community, and also sends members periodic queries (short surveys on infectious disease topics) that have addressed numerous topics relevant to both clinical infectious diseases and public health practice. The article reviews how the various functions of EIN contribute to clinical care and public health, identifies opportunities to further link clinical medicine and public health, and describes future directions for the EIN.

  20. The Infectious Diseases Society of America Emerging Infections Network: Bridging the Gap Between Clinical Infectious Diseases and Public Health

    PubMed Central

    Pillai, Satish K.; Beekmann, Susan E.; Santibanez, Scott; Polgreen, Philip M.

    2015-01-01

    In 1995, the Centers for Disease Control and Prevention granted a Cooperative Agreement Program award to the Infectious Diseases Society of America to develop a provider-based emerging infections sentinel network, the Emerging Infections Network (EIN). Over the past 17 years, the EIN has evolved into a flexible, nationwide network with membership representing a broad cross-section of infectious disease physicians. The EIN has an active electronic mail conference (listserv) that facilitates communication among infectious disease providers and the public health community, and also sends members periodic queries (short surveys on infectious disease topics) that have addressed numerous topics relevant to both clinical infectious diseases and public health practice. The article reviews how the various functions of EIN contribute to clinical care and public health, identifies opportunities to further link clinical medicine and public health, and describes future directions for the EIN. PMID:24403542

  1. Current perspectives in transfusion-transmitted infectious diseases: emerging and re-emerging infections

    PubMed Central

    Stramer, S L

    2014-01-01

    Background In August 2009, a group from the AABB (Stramer et al., Transfusion 2009;99:1S–29S, Emerging Infectious Disease Agents and their Potential Threat to Transfusion Safety; http://www.aabb.org/resources/bct/eid/Pages/default.aspx) published a Supplement to Transfusion that reviewed emerging infectious disease (EID) agents that pose a real or theoretical threat to transfusion safety, but for which an existing effective intervention is lacking. The necessary attributes for transfusion transmission were outlined including: presence of the agent in blood during the donor's asymptomatic phase, the agent's survival/persistence in blood during processing/storage, and lastly that the agent must be recognized as responsible for a clinically apparent outcome in at least a proportion of recipients who become infected. Without these attributes, agents are not considered as a transfusion-transmission threat and were excluded. Sixty-eight such agents were identified with enough evidence/likelihood of transfusion transmission (e.g., blood phase) and potential for clinical disease to warrant further consideration. In the Supplement, Fact Sheets (FS) were published providing information on: agent classification; disease agent's importance; clinical syndromes/diseases caused; transmission modes (including vectors/reservoirs); likelihood of transfusion transmission, and if proven to be transfusion-transmitted, information on known cases; the feasibility/predicted success of interventions for donor screening (questioning) and tests available for diagnostics/ adapted for donor screening; and finally, the efficacy, if known, of inactivation methods for plasma-derived products. The Supplement included a separate section on pathogen reduction using published data. Agents were prioritized relative to their scientific/epidemiologic threat and their perceived threat to the community including concerns expressed by the regulators of blood. Agents given the highest priority due to a

  2. Common and emerging infectious diseases in the animal shelter.

    PubMed

    Pesavento, P A; Murphy, B G

    2014-03-01

    The beneficial role that animal shelters play is unquestionable. An estimated 3 to 4 million animals are cared for or placed in homes each year, and most shelters promote public health and support responsible pet ownership. It is, nonetheless, inevitable that shelters are prime examples of anthropogenic biological instability: even well-run shelters often house transient, displaced, and mixed populations of animals. Many of these animals have received minimal to no prior health care, and some have a history of scavenging or predation to survive. Overcrowding and poor shelter conditions further magnify these inherent risks to create individual, intraspecies, and interspecies stress and provide an environment conducive to exposure to numerous potentially collaborative pathogens. All of these factors can contribute to the evolution and emergence of new pathogens or to alterations in virulence of endemic pathogens. While it is not possible to effectively anticipate the timing or the pathogen type in emergence events, their sites of origin are less enigmatic, and pathologists and diagnosticians who work with sheltered animal populations have recognized several such events in the past decade. This article first considers the contribution of the shelter environment to canine and feline disease. This is followed by summaries of recent research on the pathogenesis of common shelter pathogens, as well as research that has led to the discovery of novel or emerging diseases and the methods that are used for their diagnosis and discovery. For the infectious agents that commonly affect sheltered dogs and cats, including canine distemper virus, canine influenza virus, Streptococcus spp, parvoviruses, feline herpesvirus, feline caliciviruses, and feline infectious peritonitis virus, we present familiar as well as newly recognized lesions associated with infection. Preliminary studies on recently discovered viruses like canine circovirus, canine bocavirus, and feline norovirus

  3. Ills in the pipeline: emerging infectious diseases and wildlife

    USGS Publications Warehouse

    Sleeman, Jonathan M.; Gillin, Colin

    2012-01-01

    In the recent film Contagion, a medical thriller released in fall 2011, the fictitious MEV-1 virus—passed from bat to pig to humans—spreads across the globe as easily as the common cold, killing millions of humans and causing mass hysteria as medical researchers race to find a cure. Though it's Hollywood hyperbole, the film holds a kernel of truth: Researchers believe that the close proximity of Malaysian hog farms to forested areas—the natural habitat for fruit bats—allowed the previously unknown Nipah virus to spill from bats into pigs and subsequently into people, resulting in more than 100 human deaths (Epstein et al. 2006). There is no doubt that in recent times we have seen an unprecedented number of emerging infectious diseases, defined by the Institute for Medicine as new, reemerging, or drug-resistant infections whose incidence has increased or whose incidence threatens to increase in the near future. Many of these have a wildlife origin (Taylor et al. 2001). While this jump may be due, in part, to increased vigilance and reporting, there is a general consensus that current global conditions are creating a situation that is very favorable to the transmission of microbes that cause diseases. (For reviews, see Daszak et al. 2001 and Keesing et al. 2010). Likewise, it's increasingly important that wildlife professionals become aware of how and why new infectious diseases spread and what, if anything, can be done to minimize impacts on wildlife.

  4. Rapid infectious disease screening for field medical emergencies

    NASA Astrophysics Data System (ADS)

    Ho, Winston; Rao, Srivasta V.; Low, Peter W.; Hess, John R.

    2000-08-01

    Current blood tests cannot provide rapid support for field medical emergencies that require blood in excess of the tested supply, especially, when additional blood needs to be drawn from the available walking pool. A fluorescence-based rapid infectious disease screening system, based on a disposable disk with an array of wash-free, one-step, membrane strips and an array of optical probes can be used to quantify a panel of transmissible diseases in parallel with high specificity, high sensitivity, and operational simplicity. We have designed and constructed a sandwich membrane assay platform and a laboratory prototype optoelectronic measuring device and used this combined system to quantify hepatitis C antibody over the concentration range of 2 ng/ml to 100 ng/ml in 3 to 5 minutes.

  5. Antibody-based therapies for emerging infectious diseases.

    PubMed

    Casadevall, A

    1996-01-01

    In the 19th century, it was discovered that immune sera were useful in treating infectious diseases. Serum therapy was largely abandoned in the 1940s because of the toxicity associated with the administration of heterologous sera and the introduction of effective antimicrobial chemotherapy. Recent advances in the technology of monoclonal antibody production provide the means to generate human antibody reagents and reintroduce antibody therapies, while avoiding the toxicities associated with serum therapy. Because of the versatility of antibodies, antibody-based therapies could, in theory, be developed against any existing pathogen. The advantages of antibody-based therapies include versatility, low toxicity, pathogen specificity, enhancement of immune function, and favorable pharmacokinetics; the disadvantages include high cost, limited usefulness against mixed infections, and the need for early and precise microbiologic diagnosis. The potential of antibodies as antiinfective agents has not been fully tapped. Antibody-based therapies constitute a potentially useful option against newly emergent pathogens.

  6. DNA vaccines for emerging infectious diseases: what if?

    PubMed Central

    Whalen, R. G.

    1996-01-01

    A novel and powerful method for vaccine research, colloquially known as DNA vaccines, involves the deliberate introduction into tissues of a DNA plasmid carrying an antigen-coding gene that transfects cells in vivo and results in an immune response. DNA vaccines have several distinct advantages, which include ease of manipulation, use of a generic technology, simplicity of manufacture, and chemical and biological stability. In addition, DNA vaccines are a great leveler among re-searchers around the world because they provide unprecedented ease of experi-mentation. To facilitate diffusion of information, an Internet site has been established called THE DNA VACCINE WEB (URL:http://www.genweb.com/dnavax/dnavax.html). In this review, a brief survey is undertaken of the experimental models and preclinical work on DNA vaccines to contribute to a greater awareness of the possibilities for emerging infectious diseases. PMID:8903226

  7. Bats as reservoirs of severe emerging infectious diseases.

    PubMed

    Han, Hui-Ju; Wen, Hong-ling; Zhou, Chuan-Min; Chen, Fang-Fang; Luo, Li-Mei; Liu, Jian-wei; Yu, Xue-Jie

    2015-07-02

    In recent years severe infectious diseases have been constantly emerging, causing panic in the world. Now we know that many of these terrible diseases are caused by viruses originated from bats (Table 1), such as Ebola virus, Marburg, SARS coronavirus (SARS-CoV), MERS coronavirus (MERS-CoV), Nipah virus (NiV) and Hendra virus (HeV). These viruses have co-evolved with bats due to bats' special social, biological and immunological features. Although bats are not in close contact with humans, spillover of viruses from bats to intermediate animal hosts, such as horses, pigs, civets, or non-human primates, is thought to be the most likely mode to cause human infection. Humans may also become infected with viruses through aerosol by intruding into bat roosting caves or via direct contact with bats, such as catching bats or been bitten by bats.

  8. Selected Pathogens of Concern to Industrial Food Processors: Infectious, Toxigenic, Toxico-Infectious, Selected Emerging Pathogenic Bacteria

    NASA Astrophysics Data System (ADS)

    Behling, Robert G.; Eifert, Joseph; Erickson, Marilyn C.; Gurtler, Joshua B.; Kornacki, Jeffrey L.; Line, Erick; Radcliff, Roy; Ryser, Elliot T.; Stawick, Bradley; Yan, Zhinong

    This chapter, written by several contributing authors, is devoted to discussing selected microbes of contemporary importance. Microbes from three categories are described by the following: (1) infectious invasive agents like Salmonella, Listeria monocytogenes, and Campylobacter; (2) toxigenic pathogens such as Staphylococcus aureus, Bacillus cereus, and Clostridium botulinum; and (3) toxico-infectious agents like enterohemorrhagic Escherichia coli and Clostridium perfringens. In addition, emerging pathogens, like Cronobacter (Enterobacter) sakazakii, Arcobacter spp., and Mycobacterium avium subspecies paratuberculosis are also described.

  9. Sliding mode control of outbreaks of emerging infectious diseases.

    PubMed

    Xiao, Yanni; Xu, Xiaxia; Tang, Sanyi

    2012-10-01

    This paper proposes and analyzes a mathematical model of an infectious disease system with a piecewise control function concerning threshold policy for disease management strategy. The proposed models extend the classic models by including a piecewise incidence rate to represent control or precautionary measures being triggered once the number of infected individuals exceeds a threshold level. The long-term behaviour of the proposed non-smooth system under this strategy consists of the so-called sliding motion-a very rapid switching between application and interruption of the control action. Model solutions ultimately approach either one of two endemic states for two structures or the sliding equilibrium on the switching surface, depending on the threshold level. Our findings suggest that proper combinations of threshold densities and control intensities based on threshold policy can either preclude outbreaks or lead the number of infected to a previously chosen level.

  10. Emerging, evolving, and established infectious diseases and interventions.

    PubMed

    Halloran, M Elizabeth; Longini, Ira M

    2014-09-12

    Planning, implementing, and evaluating interventions against infectious diseases depend on the nature of the infectious disease; the availability of intervention measures; and logistical, economic, and political constraints. Infectious diseases and vaccine- or drug-based interventions can be loosely categorized by the degree to which the infectious disease and the intervention are well established. Pertussis, polio, and measles are three examples of long-known infectious diseases for which global vaccination has dramatically reduced the public health burden. Pertussis vaccination was introduced in the 1940s, polio vaccination in the 1950s, and measles vaccination in the 1960s, nearly eliminating these diseases in many places.

  11. Emerging infectious diseases with cutaneous manifestations: Viral and bacterial infections.

    PubMed

    Nawas, Zeena Y; Tong, Yun; Kollipara, Ramya; Peranteau, Andrew J; Woc-Colburn, Laila; Yan, Albert C; Lupi, Omar; Tyring, Stephen K

    2016-07-01

    Given increased international travel, immigration, and climate change, bacterial and viral infections that were once unrecognized or uncommon are being seen more frequently in the Western Hemisphere. A delay in diagnosis and treatment of these diseases can lead to significant patient morbidity and mortality. However, the diagnosis and management of these infections is fraught with a lack of consistency because there is a dearth of dermatology literature on the cutaneous manifestations of these infections. We review the epidemiology, cutaneous manifestations, diagnosis, and management of these emerging bacterial and viral diseases.

  12. An Emerging Infectious Disease Triggering Large-Scale Hyperpredation

    PubMed Central

    Moleón, Marcos; Almaraz, Pablo; Sánchez-Zapata, José A.

    2008-01-01

    Hyperpredation refers to an enhanced predation pressure on a secondary prey due to either an increase in the abundance of a predator population or a sudden drop in the abundance of the main prey. This scarcely documented mechanism has been previously studied in scenarios in which the introduction of a feral prey caused overexploitation of native prey. Here we provide evidence of a previously unreported link between Emergent Infectious Diseases (EIDs) and hyperpredation on a predator-prey community. We show how a viral outbreak caused the population collapse of a host prey at a large spatial scale, which subsequently promoted higher-than-normal predation intensity on a second prey from shared predators. Thus, the disease left a population dynamic fingerprint both in the primary host prey, through direct mortality from the disease, and indirectly in the secondary prey, through hyperpredation. This resulted in synchronized prey population dynamics at a large spatio-temporal scale. We therefore provide evidence for a novel mechanism by which EIDs can disrupt a predator-prey interaction from the individual behavior to the population dynamics. This mechanism can pose a further threat to biodiversity through the human-aided disruption of ecological interactions at large spatial and temporal scales. PMID:18523587

  13. Polycystic kidney disease: an unrecognized emerging infectious disease?

    PubMed Central

    Miller-Hjelle, M. A.; Hjelle, J. T.; Jones, M.; Mayberry, W. R.; Dombrink-Kurtzman, M. A.; Peterson, S. W.; Nowak, D. M.; Darras, F. S.

    1997-01-01

    Polycystic kidney disease (PKD) is one of the most common genetic diseases in humans. We contend that it may be an emerging infectious disease and/or microbial toxicosis in a vulnerable human subpopulation. Use of a differential activation protocol for the Limulus amebocyte lysate (LAL) assay showed bacterial endotoxin and fungal (1-->3)-beta-D-glucans in cyst fluids from human kidneys with PKD. Fatty acid analysis of cyst fluid confirmed the presence of 3-hydroxy fatty acids characteristic of endotoxin. Tissue and cyst fluid from three PKD patients were examined for fungal components. Serologic tests showed Fusarium, Aspergillus, and Candida antigens. IgE, but not IgG, reactive with Fusarium and Candida were also detected in cyst fluid. Fungal DNA was detected in kidney tissue and cyst fluid from these three PKD patients, but not in healthy human kidney tissue. We examine the intertwined nature of the actions of endotoxin and fungal components, sphingolipid biology in PKD, the structure of PKD gene products, infections, and integrity of gut function to establish a mechanistic hypothesis for microbial provocation of human cystic disease. Proof of this hypothesis will require identification of the microbes and microbial components involved and multifaceted studies of PKD cell biology. PMID:9204292

  14. Infectious waste management in Japan: A revised regulation and a management process in medical institutions

    SciTech Connect

    Miyazaki, M. . E-mail: motonobu@cis.fukuoka-u.ac.jp; Une, H.

    2005-07-01

    In Japan, the waste management practice is carried out in accordance with the Waste Disposal Law of 1970. The first rule of infectious waste management was regulated in 1992, and infectious wastes are defined as the waste materials generated in medical institutions as a result of medical care or research which contain pathogens that have the potential to transmit infectious diseases. Revised criteria for infectious waste management were promulgated by the Ministry of Environment in 2004. Infectious waste materials are divided into three categories: the form of waste; the place of waste generation; the kind of infectious diseases. A reduction of infectious waste is expected. We introduce a summary of the revised regulation of infectious waste management in this article.

  15. Postexposure management of healthcare personnel to infectious diseases.

    PubMed

    Bader, Mazen S; Brooks, Annie A; Srigley, Jocelyn A

    2015-01-01

    Healthcare personnel (HCP) are at risk of exposure to various pathogens through their daily tasks and may serve as a reservoir for ongoing disease transmission in the healthcare setting. Management of HCP exposed to infectious agents can be disruptive to patient care, time-consuming, and costly. Exposure of HCP to an infectious source should be considered an urgent medical concern to ensure timely management and administration of postexposure prophylaxis, if available and indicated. Infection control and occupational health departments should be notified for management of exposed HCP, identification of all contacts of the index case, and application of immediate infection control measures for the index case and exposed HCP, if indicated. This article reviews the main principles of postexposure management of HCP to infectious diseases, in general, and to certain common infections, in particular, categorized by their route of transmission, in addition to primary prevention of these infections.

  16. Bartonellosis: one health perspectives for an emerging infectious disease.

    PubMed

    Breitschwerdt, Edward Bealmear

    2014-01-01

    In recent years, an increasing number of Bartonella species have been identified as zoonotic pathogens, transmitted by animal bites, scratches, arthropods and even by needle sticks. Considering the diversity of newly discovered Bartonella species and subspecies and the large number and ecologically diverse animal reservoir hosts and the evolving spectrum of arthropod vectors that can transmit these bacteria among animals and humans, the clinical and diagnostic challenges posed by Bartonella transmission in nature are presumably much more complex than is currently appreciated by diagnosticians, vector biologists, ecologists, physicians, or veterinarians. Historically the term "bartonellosis" was attributed to infections with Bartonella bacilliformis, transmitted by sandflies in the Peruvian Andes. Currently, however, bartonellosis now includes infections caused by any Bartonella sp. anywhere in the world. Potentially, because Bartonella spp. can infect erythrocytes, endothelial cells, pericytes, CD34(+) progenitor cells, and various macrophage-type cells, including microglial cells, dendritic cells, and circulating monocytes in vitro, the clinical and pathological manifestations of bartonellosis appear to be very diverse in both sick animals and human patients. Because 75% of emerging infectious diseases are zoonoses, many of which are vector-transmitted by an arthropod, a One Health approach to bartonellosis and other zoonotic infections is needed to properly address animal health, public health, and environmental factors that influence the distribution and transmission of these bacteria. The One Health concept encourages a spirit of cooperation among animal, environmental, and human health professionals and promotes developing integrated solutions for complex problems that impact the health of animals, humans, and the planet. Importantly, substantial research is needed to define the medical importance of this genus as a cause of animal and human illnesses.

  17. Fire service emergency management handbook

    NASA Astrophysics Data System (ADS)

    1985-01-01

    This planning guide was prepared for the Federal Emergency Management Agency by the International Association of Fire Chiefs as part of an effort to update and improve emergency management information available to the fire service. Intended as a primary source for fire chiefs, fire executives, and planners, it incorporates the following main topic areas: instruction for the use of the handbook; description of the emergency management process; and checklists for specific hazards. The volume includes a self evaluation form for determining community risk, concepts of emergency management, and specific steps in community risk reduction in the four phases of emergency management process. Sample forms, tables, and letters of agreement are also included.

  18. Hot spots in a wired world: WHO surveillance of emerging and re-emerging infectious diseases.

    PubMed

    Heymann, D L; Rodier, G R

    2001-12-01

    The resurgence of the microbial threat, rooted in several recent trends, has increased the vulnerability of all nations to the risk of infectious diseases, whether newly emerging, well-established, or deliberately caused. Infectious disease intelligence, gleaned through sensitive surveillance, is the best defence. The epidemiological and laboratory techniques needed to detect, investigate, and contain a deliberate outbreak are the same as those used for natural outbreaks. In April 2000, WHO formalised an infrastructure (the Global Outbreak Alert and Response Network) for responding to the heightened need for early awareness of outbreaks and preparedness to respond. The Network, which unites 110 existing networks, is supported by several new mechanisms and a computer-driven tool for real time gathering of disease intelligence. The procedure for outbreak alert and response has four phases: systematic detection, outbreak verification, real time alerts, and rapid response. For response, the framework uses different strategies for combating known risks and unexpected events, and for improving both global and national preparedness. New forces at work in an electronically interconnected world are beginning to break down the traditional reluctance of countries to report outbreaks due to fear of the negative impact on trade and tourism. About 65% of the world's first news about infectious disease events now comes from informal sources, including press reports and the internet.

  19. Population dynamics of epidemic and endemic states of drug-resistance emergence in infectious diseases

    PubMed Central

    Knipl, Diána; Röst, Gergely

    2017-01-01

    The emergence and spread of drug-resistance during treatment of many infectious diseases continue to degrade our ability to control and mitigate infection outcomes using therapeutic measures. While the coverage and efficacy of treatment remain key factors in the population dynamics of resistance, the timing for the start of the treatment in infectious individuals can significantly influence such dynamics. We developed a between-host disease transmission model to investigate the short-term (epidemic) and long-term (endemic) states of infections caused by two competing pathogen subtypes, namely the wild-type and resistant-type, when the probability of developing resistance is a function of delay in start of the treatment. We characterize the behaviour of disease equilibria and obtain a condition to minimize the fraction of population infectious at the endemic state in terms of probability of developing resistance and its transmission fitness. For the short-term epidemic dynamics, we illustrate that depending on the likelihood of resistance development at the time of treatment initiation, the same epidemic size may be achieved with different delays in start of the treatment, which may correspond to significantly different treatment coverages. Our results demonstrate that early initiation of treatment may not necessarily be the optimal strategy for curtailing the incidence of resistance or the overall disease burden. The risk of developing drug-resistance in-host remains an important factor in the management of resistance in the population. PMID:28097052

  20. Prevention and Management of Infectious Complications of Percutaneous Interventions

    PubMed Central

    Huang, Steven Y.; Philip, Asher; Richter, Michael D.; Gupta, Sanjay; Lessne, Mark L.; Kim, Charles Y.

    2015-01-01

    Infectious complications following interventional radiology (IR) procedures can cause significant patient morbidity and, potentially, mortality. As the number and breadth of IR procedures grow, it becomes increasingly evident that interventional radiologists must possess a thorough understanding of these potential infectious complications. Furthermore, given the increasing incidence of antibiotic-resistant bacteria, emphasis on cost containment, and attention to quality of care, it is critical to have infection control strategies to maximize patient safety. This article reviews infectious complications associated with percutaneous ablation of liver tumors, transarterial embolization of liver tumors, uterine fibroid embolization, percutaneous nephrostomy, percutaneous biliary interventions, central venous catheters, and intravascular stents. Emphasis is placed on incidence, risk factors, prevention, and management. With the use of these strategies, IR procedures can be performed with reduced risk of infectious complications. PMID:26038616

  1. A curriculum for training healthcare workers in the management of highly infectious diseases.

    PubMed

    Baka, A; Fusco, F M; Puro, V; Vetter, N; Skinhoj, P; Ott, K; Siikamaki, H; Brodt, H R; Gottschalk, R; Follin, P; Bannister, B; De Carli, G; Nisii, C; Heptonstall, J; Ippolito, G

    2007-06-01

    The SARS epidemic, the threat of bioterrorism, and recent examples of imported highly infectious diseases (HID) in Europe have all highlighted the importance of competent clinical and public health management of infectious disease emergencies. Although the European Union of Medical Specialists in Europe and the Infectious Diseases Society of America have developed curricula for training in infectious disease medicine, neither of those mentions training in the management of HIDs. The European Network for Infectious Diseases (EUNID, http://www.eunid.com) is a European Commission co-funded network of experts in HID management, created to help improve the preparedness for HID emergencies within Europe. One of EUNID's agreed tasks is the development of a curriculum for such a training. Between April 2005 and September 2006, EUNID developed a curriculum and accompanying training course on the basis of a questionnaire that was sent to all country representatives and discussion, followed by amendment of drafts shared through the project website, and a final consensus meeting. The resulting curriculum consists of a two-module course covering the core knowledge and skills that healthcare workers need to safely treat a patient who has, or who may have, an HID. The first module introduces theoretical aspects of HID management, including disease-specific knowledge, infection control, and the public health response, through didactic teaching and class-based discussion. The second module involves a "skill station" and a clinical scenario, and equips trainees with relevant practical skills, including the use of specialised equipment and teamwork practice in patient management. Together, the curriculum and course contribute to the creation of a common framework for training healthcare professionals in Europe, and although they are designed primarily for clinicians that are directly involved in patient care, they are relevant also to public health professionals and others who may be

  2. Characteristics and management of infectious industrial waste in Taiwan.

    PubMed

    Huang, Mei-Chuan; Lin, Jim Juimin

    2008-11-01

    Infectious industrial waste management in Taiwan is based on the specific waste production unit. In other countries, management is based simply on whether the producer may lead to infectious disease. Thus, Taiwan has a more detailed classification of infectious waste. The advantage of this classification is that it is easy to identify the sources, while the disadvantage lies in the fact that it is not flexible and hence increases cost. This study presents an overview of current management practices for handling infectious industrial waste in Taiwan, and addresses the current waste disposal methods. The number of small clinics in Taiwan increased from 18,183 to 18,877 between 2003 and 2005. Analysis of the data between 2003 and 2005 showed that the majority of medical waste was general industrial waste, which accounted for 76.9%-79.4% of total medical waste. Infectious industrial waste accounted for 19.3%-21.9% of total medical waste. After the SARS event in Taiwan, the amount of infectious waste reached 19,350 tons in 2004, an increase over the previous year of 4000 tons. Waste minimization was a common consideration for all types of waste treatment. In this study, we summarize the percentage of plastic waste in flammable infectious industrial waste generated by medical units, which, in Taiwan was about 30%. The EPA and Taiwan Department of Health have actively promoted different recycling and waste reduction measures. However, the wide adoption of disposable materials made recycling and waste reduction difficult for some hospitals. It has been suggested that enhancing the education of and promoting communication between medical units and recycling industries must be implemented to prevent recyclable waste from entering the incinerator.

  3. Characteristics and management of infectious industrial waste in Taiwan

    SciTech Connect

    Huang, M.-C. Lin, Jim Juimin

    2008-11-15

    Infectious industrial waste management in Taiwan is based on the specific waste production unit. In other countries, management is based simply on whether the producer may lead to infectious disease. Thus, Taiwan has a more detailed classification of infectious waste. The advantage of this classification is that it is easy to identify the sources, while the disadvantage lies in the fact that it is not flexible and hence increases cost. This study presents an overview of current management practices for handling infectious industrial waste in Taiwan, and addresses the current waste disposal methods. The number of small clinics in Taiwan increased from 18,183 to 18,877 between 2003 and 2005. Analysis of the data between 2003 and 2005 showed that the majority of medical waste was general industrial waste, which accounted for 76.9%-79.4% of total medical waste. Infectious industrial waste accounted for 19.3%-21.9% of total medical waste. After the SARS event in Taiwan, the amount of infectious waste reached 19,350 tons in 2004, an increase over the previous year of 4000 tons. Waste minimization was a common consideration for all types of waste treatment. In this study, we summarize the percentage of plastic waste in flammable infectious industrial waste generated by medical units, which, in Taiwan was about 30%. The EPA and Taiwan Department of Health have actively promoted different recycling and waste reduction measures. However, the wide adoption of disposable materials made recycling and waste reduction difficult for some hospitals. It has been suggested that enhancing the education of and promoting communication between medical units and recycling industries must be implemented to prevent recyclable waste from entering the incinerator.

  4. Update on the Management of Infectious Keratitis.

    PubMed

    Austin, Ariana; Lietman, Tom; Rose-Nussbaumer, Jennifer

    2017-09-20

    Infectious keratitis is a major global cause of visual impairment and blindness, often affecting marginalized populations. Proper diagnosis of the causative organism is critical, and although culture remains the prevailing diagnostic tool, newer techniques such as in vivo confocal microscopy are helpful for diagnosing fungus and Acanthamoeba. Next-generation sequencing holds the potential for early and accurate diagnosis even for organisms that are difficult to culture by conventional methods. Topical antibiotics remain the best treatment for bacterial keratitis, and a recent review found all commonly prescribed topical antibiotics to be equally effective. However, outcomes remain poor secondary to corneal melting, scarring, and perforation. Adjuvant therapies aimed at reducing the immune response associated with keratitis include topical corticosteroids. The large, randomized, controlled Steroids for Corneal Ulcers Trial found that although steroids provided no significant improvement overall, they did seem beneficial for ulcers that were central, deep or large, non-Nocardia, or classically invasive Pseudomonas aeruginosa; for patients with low baseline vision; and when started early after the initiation of antibiotics. Fungal ulcers often have worse clinical outcomes than bacterial ulcers, with no new treatments since the 1960s when topical natamycin was introduced. The randomized controlled Mycotic Ulcer Treatment Trial (MUTT) I showed a benefit of topical natamycin over topical voriconazole for fungal ulcers, particularly among those caused by Fusarium. MUTT II showed that oral voriconazole did not improve outcomes overall, although there may have been some effect among Fusarium ulcers. Given an increase in nonserious adverse events, the authors concluded that they could not recommend oral voriconazole. Viral keratitis differs from bacterial and fungal cases in that it is often recurrent and is common in developed countries. The Herpetic Eye Disease Study

  5. Intracranial infectious aneurysm: presentation, management and outcome.

    PubMed

    Kannoth, Sudheeran; Iyer, Rajesh; Thomas, Sanjeev V; Furtado, Sunil V; Rajesh, B J; Kesavadas, C; Radhakrishnan, V V; Sarma, P S

    2007-05-15

    Intracranial infectious aneurysms (IA) are infrequent, but can be fatal. To compare the clinical profile of IAs associated with intravascular/systemic infection like infective endocarditis with that associated with local infections like meningitis, orbital cellulitis and cavernous sinus thrombosis. We analysed all cases of IA, treated in this Institute from 1976 to 2003, in order to identify prognostic factors. There were 25 persons (mean age 24.8+/-17.3 years, males 17) with 29 IA (carotid circulation 19, vertebrobasilar circulation 10). Headache (83%) and fever (67%) were the most common presenting symptoms. In contrast to noninfectious aneurysms, intracerebral haemorrhage (60%) and focal signs were more common than subarachnoid haemorrhage (7%) with IA. Sources of infection were cardiac (10), meningitis (12), orbital cellulitis (2) or uncertain (1). Infective agents included bacteria (18), fungi (4), and tubercle bacilli (3). Fifteen IA were distal and 14 were proximal. IAs associated with meningitis were proximal (75%) while those associated with cardiac diseases preferentially involved carotid territory and were distal (p=0.013). The overall mortality was 32%. Survivors were younger than those who expired (p=0.015). Of the sixteen patients treated medically, seven recovered (44%), others (56%) had treatment failure (three died and six required surgery later). Another five patients underwent early surgery (one died). Mortality of IA was significantly higher with meningitis, fungal aetiology and vertebrobasilar location. IAs associated with local infections like meningitis had different clinical profile as compared to IAs associated with intravascular/systemic infections like infective endocarditis.

  6. Military-civilian cooperative emergency response to infectious disease prevention and control in China.

    PubMed

    Ma, Hui; Dong, Ji-Ping; Zhou, Na; Pu, Wei

    2016-01-01

    In recent years, the incidence of severe infectious diseases has increased, and the number of emerging infectious diseases continues to increase. The Chinese government and military forces have paid a great deal of attention to infectious disease prevention and control, and using military-civilian cooperation, they have successfully prevented numerous severe epidemic situations, such as severe acute respiratory syndrome (SARS), influenza A (H1N1), avian influenza H5N1 and H7N9, and Ebola hemorrhagic fever, while actively maintained public health, economic development, and national construction. This paper focuses on the mechanisms of the military-cooperative emergency response to infectious diseases--the joint working mechanism, the information-sharing mechanism, the research collaboration mechanism, and the joint disposal mechanism--and presents a sorted summary of the practices and experiences of cooperative emergency responses to infectious diseases. In the future, the Chinese military and the civilian sector will further strengthen the cooperative joint command system and emergency rescue force and will reinforce their collaborative information-sharing platform and technical equipment system to further improve military-civilian collaborative emergency infectious diseases disposal, advance the level of infectious disease prevention and control, and maintain public health.

  7. Emerging infectious diseases of wildlife: role in amphibian population declines and global implications

    USGS Publications Warehouse

    Daszak, P.; Berger, Lee; Cunningham, A.A.; Hyatt, A.D.; Green, D.E.; Speare, R.

    1999-01-01

    We review recent research on the pathology, ecology, and biogeography of two emerging infectious wildlife diseases, chytridiomycosis and ranaviral disease, in the context of host-parasite population biology. We examine the role of these diseases in the global decline of amphibian populations and propose hypotheses for the origins and impact of these panzootics. Finally, we discuss emerging infectious diseases as a global threat to wildlife populations.

  8. Managing the Navy’s Infectious Medical Waste

    DTIC Science & Technology

    1992-08-04

    or indusrial laboratories present the double hazard of inflicting injury and inducing disease. These wastes should be managed as infectious wastes...commercial facility, there are also various hazardous wastes that can be generated by the facilities maintenance , consuuction or transportation...Moderate Maintenance Coats Hfigh Low Moderate. Moderate Downtime Hfigh LOW Moderate Moderate 6.1 Incineration In 1989, an American Hospital Association

  9. Origin and invasion of the emerging infectious pathogen Sphaerothecum destruens.

    PubMed

    Sana, Salma; Hardouin, Emilie A; Gozlan, Rodolphe E; Ercan, Didem; Tarkan, Ali Serhan; Zhang, Tiantian; Andreou, Demetra

    2017-08-23

    Non-native species are often linked to the introduction of novel pathogens with detrimental effects on native biodiversity. Since Sphaerothecum destruens was first discovered as a fish pathogen in the United Kingdom, it has been identified as a potential threat to European fish biodiversity. Despite this parasite's emergence and associated disease risk, there is still a poor understanding of its origin in Europe. Here, we provide the first evidence to support the hypothesis that S. destruens was accidentally introduced to Europe from China along with its reservoir host Pseudorasbora parva via the aquaculture trade. This is the first study to confirm the presence of S. destruens in China, and it has expanded the confirmed range of S. destruens to additional locations in Europe. The demographic analysis of S. destruens and its host P. parva in their native and invasive range further supported the close association of both species. This research has direct significance and management implications for S. destruens in Europe as a non-native parasite.

  10. Land-Use Change and Emerging Infectious Disease on an Island Continent

    PubMed Central

    McFarlane, Rosemary A.; Sleigh, Adrian C.; McMichael, Anthony J.

    2013-01-01

    A more rigorous and nuanced understanding of land-use change (LUC) as a driver of emerging infectious disease (EID) is required. Here we examine post hunter-gatherer LUC as a driver of infectious disease in one biogeographical region with a compressed and documented history—continental Australia. We do this by examining land-use and native vegetation change (LUCC) associations with infectious disease emergence identified through a systematic (1973–2010) and historical (1788–1973) review of infectious disease literature of humans and animals. We find that 22% (20) of the systematically reviewed EIDs are associated with LUCC, most frequently where natural landscapes have been removed or replaced with agriculture, plantations, livestock or urban development. Historical clustering of vector-borne, zoonotic and environmental disease emergence also follows major periods of extensive land clearing. These advanced stages of LUCC are accompanied by changes in the distribution and density of hosts and vectors, at varying scales and chronology. This review of infectious disease emergence in one continent provides valuable insight into the association between accelerated global LUC and concurrent accelerated infectious disease emergence. PMID:23812027

  11. Identifying the Emergency Management Profession.

    ERIC Educational Resources Information Center

    Chiesa, Adele M.

    1987-01-01

    In building an emergency management library collection within a training institution, technical data become secondary to identifying common goals, methods, and systems found at the federal, state, and local levels for responding to and planning for disasters and crises. These goals help identify emergency management skills public officials should…

  12. Addressing emerging infectious disease threats: a prevention strategy for the United States. Executive summary.

    PubMed

    1994-04-15

    The spectrum of infectious disease is changing rapidly in conjunction with dramatic societal and environmental changes. Worldwide, explosive population growth with expanding poverty and urban migration is occurring; international travel and commerce are increasing; and technology is rapidly changing-all of which affect the risk of exposure to infectious agents. Recent examples of important emerging infectious diseases include prolonged diarrheal illness due to waterborne cryptosporidium, hemorrhagic colitis and renal failure from foodborne Escherichia coli O157:H7, pneumonia and middle-ear infections caused by drug-resistant pneumococci, and rodentborne hantavirus pulmonary syndrome. These diseases as well as resurgent diseases (e.g., tuberculosis and cholera) illustrate human vulnerability to microorganisms in the environment. Three recent reports by the Institute of Medicine document the need to address emerging infectious disease threats. In partnership with representatives from health departments, other federal agencies, medical and public health professional associations, and international organizations, CDC has developed a strategic plan to address emerging infectious disease threats. The plain contains four goals that emphasize surveillance, applied research, prevention and control, and public health infrastructure. To ensure sustainability, plan implementation will be approached in stages, as a long-term endeavor with emphasis on extramural programs. As health-care reform proceeds, priority should be given to strengthening partnerships between health-care providers, microbiologists, and public health professionals to detect and control emerging infectious diseases.

  13. Emerging infectious disease agents and blood safety in Australia: spotlight on Zika virus.

    PubMed

    Kiely, Philip; Wood, Erica M; Gambhir, Manoj; Cheng, Allen C; McQuilten, Zoe K; Seed, Clive R

    2017-06-05

    Emerging infectious diseases (EIDs) are infectious diseases whose incidence has increased in humans in the past 20 years or could increase in the near future. EID agents may represent a threat to blood safety if they infect humans, cause a clinically significant illness, include an asymptomatic blood phase in the course of infection, and are transmissible by transfusion. EID agents are typically not well characterised, but there is a consensus that we can expect ongoing outbreaks. Strategies to manage the risk to blood safety from EIDs include ongoing surveillance, regular risk assessments, modelling transfusion transmission risk, and deferral of donors with a recent travel history to outbreak areas. The 2015-16 Zika virus (ZIKV) outbreak in the Americas is the largest reported ZIKV outbreak to date, and it highlights the unpredictable nature of EID outbreaks and how quickly they can become a major public health problem. This ZIKV outbreak has provided evidence of a causal link between the virus and microcephaly in newborns. In assessing the potential risk of ZIKV to blood safety in Australia, it should be noted that a relatively small number of imported ZIKV infections have been reported in Australia, there have been no reported cases of local ZIKV transmission, and the geographical distribution of the potential ZIKV mosquito vector in Australia (Aedes aegypti) is limited to northern Queensland. Moreover, reported transfusion-transmitted ZIKV cases worldwide are rare. At present, ZIKV represents a low risk to blood safety in Australia.

  14. Wild primate populations in emerging infectious disease research: the missing link?

    PubMed Central

    Wolfe, N. D.; Escalante, A. A.; Karesh, W. B.; Kilbourn, A.; Spielman, A.; Lal, A. A.

    1998-01-01

    Wild primate populations, an unexplored source of information regarding emerging infectious disease, may hold valuable clues to the origins and evolution of some important pathogens. Primates can act as reservoirs for human pathogens. As members of biologically diverse habitats, they serve as sentinels for surveillance of emerging pathogens and provide models for basic research on natural transmission dynamics. Since emerging infectious diseases also pose serious threats to endangered and threatened primate species, studies of these diseases in primate populations can benefit conservation efforts and may provide the missing link between laboratory studies and the well-recognized needs of early disease detection, identification, and surveillance. PMID:9621185

  15. DARWIN'S NECESSARY MISFIT AND THE SLOSHING BUCKET: THE EVOLUTIONARY BIOLOGY OF EMERGING INFECTIOUS DISEASES.

    USDA-ARS?s Scientific Manuscript database

    Evolutionary studies suggest that the potential for rapid emergence of novel host-parasite associations appears to be a “built-in feature” of the complex phenomenon that is Darwinian evolution. The current Emerging Infectious Disease (EID) crisis is thus a new manifestation of an old and repeating p...

  16. Emerging infectious diseases: memorandum from a WHO meeting.

    PubMed Central

    1994-01-01

    A meeting of international experts exchanged information on recent activities dealing with new, emerging and re-emerging diseases, discussed ways of responding to this problem and to other communicable disease threats, and reviewed WHO's activities and role in this area. This Memorandum summarizes the various presentations and concludes with the recommendations and specific tasks for action at every level. PMID:7867129

  17. Emerging infectious diseases: Memorandum from a WHO meeting*

    PubMed Central

    1998-01-01

    A meeting of international experts exchanged information on recent activities dealing with new, emerging and re-emerging diseases, discussed ways of responding to this problem and to other communicable disease threats, and reviewed WHO's activities and role in this area. This Memorandum summarizes the various presentations and concludes with the recommendations and specific tasks for action at every level.

  18. Economic growth, urbanization, globalization, and the risks of emerging infectious diseases in China: A review.

    PubMed

    Wu, Tong; Perrings, Charles; Kinzig, Ann; Collins, James P; Minteer, Ben A; Daszak, Peter

    2017-02-01

    Three interrelated world trends may be exacerbating emerging zoonotic risks: income growth, urbanization, and globalization. Income growth is associated with rising animal protein consumption in developing countries, which increases the conversion of wild lands to livestock production, and hence the probability of zoonotic emergence. Urbanization implies the greater concentration and connectedness of people, which increases the speed at which new infections are spread. Globalization-the closer integration of the world economy-has facilitated pathogen spread among countries through the growth of trade and travel. High-risk areas for the emergence and spread of infectious disease are where these three trends intersect with predisposing socioecological conditions including the presence of wild disease reservoirs, agricultural practices that increase contact between wildlife and livestock, and cultural practices that increase contact between humans, wildlife, and livestock. Such an intersection occurs in China, which has been a "cradle" of zoonoses from the Black Death to avian influenza and SARS. Disease management in China is thus critical to the mitigation of global zoonotic risks.

  19. EcoHealth Consortium Workshop on Emerging Infectious Diseases and Information Technology

    DTIC Science & Technology

    2005-10-01

    for Tropical Medicine and Infectious Diseases, University of Hawai‘i at Manoa, bwilcox@hawaii.edu 2 Sustainable Resources Group Intn’l, Inc...EcoHealth 2(1): 38-46. Kaneshiro, K., P. Chinn, et al. (2005). “Hawaii’s Mountain-to-Sea Ecosystems: Social-Ecological Microcosms for Sustainability ...Incorporating Transdisciplinary Approaches to Understand Infectious Disease Emergence.” EcoHealth 2(4): 291-306. Wilcox, B. and R. Colwell (2005

  20. Infectious disease management in primary care: perceptions of GPs.

    PubMed

    Björkman, Ingeborg; Erntell, Mats; Röing, Marta; Lundborg, Cecilia Stålsby

    2011-01-11

    It is important to keep the level of antibiotic prescribing low to contain the development of resistant bacteria. This study was conducted to reveal new knowledge about how GPs think in relation to the prescribing of antibiotics - knowledge that could be used in efforts toward rational treatment of infectious diseases in primary care. The aim was to explore and describe the variations in GPs' perceptions of infectious disease management, with special reference to antibiotic prescribing. Twenty GPs working at primary care centres in a county in south-west Sweden were purposively selected based on the strategy of including GPs with different kinds of experience. The GPs were interviewed and perceptions among GPs were analysed by a phenomenographic approach. Five qualitatively different perceptions of infectious disease management were identified. They were: (A) the GP must help the patient to achieve health and well-being; (B) the management must meet the GP's perceived personal, professional and organisational demands; (C) restrictive antibiotic prescribing is time-consuming; (D) restrictive antibiotic prescribing can protect the effectiveness of antibiotics; and (E) patients benefit personally from restrictive antibiotic prescribing. Restrictive antibiotic prescribing was considered important in two perceptions, was not an issue as such in two others, and was considered in one perception although the actual prescribing was greatly influenced by the interaction between patient and GP. Accordingly, to encourage restrictive antibiotic prescribing several aspects must be addressed. Furthermore, different GPs need various kinds of support. Infectious disease management in primary care is complex and time-consuming, which must be acknowledged in healthcare organisation and planning.

  1. How urbanization affects the epidemiology of emerging infectious diseases

    PubMed Central

    Neiderud, Carl-Johan

    2015-01-01

    The world is becoming more urban every day, and the process has been ongoing since the industrial revolution in the 18th century. The United Nations now estimates that 3.9 billion people live in urban centres. The rapid influx of residents is however not universal and the developed countries are already urban, but the big rise in urban population in the next 30 years is expected to be in Asia and Africa. Urbanization leads to many challenges for global health and the epidemiology of infectious diseases. New megacities can be incubators for new epidemics, and zoonotic diseases can spread in a more rapid manner and become worldwide threats. Adequate city planning and surveillance can be powerful tools to improve the global health and decrease the burden of communicable diseases. PMID:26112265

  2. Nosocomial infection control in healthcare settings: Protection against emerging infectious diseases.

    PubMed

    Fu, Chuanxi; Wang, Shengyong

    2016-04-12

    The Middle East respiratory syndrome (MERS) outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented. Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative. Infection control in healthcare settings, in which patients with emerging infectious diseases such as MERS, Ebola virus disease, and the severe acute respiratory syndrome (SARS) are diagnosed and treated, are often imperfect. When it comes to emerging or unknown infectious diseases, before the imported case was finally identified or community transmission was reported, cases have often occurred in clusters in healthcare settings. Nosocomial infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases.

  3. A world wide public health problem: the principal re-emerging infectious diseases.

    PubMed

    De Luca D'Alessandro, E; Giraldi, G

    2011-01-01

    The extraordinary progress in the knowledge of infectious disease, the discovery of antibiotics and effective vaccines are among the great achievement of the nineteenth and twentieth centuries. These achievement have led to a dramatic reduction in the levels of mortality from these diseases. According to the World Health Organization, the term "re-emerging infectious diseases" refers to infectious diseases, which although well known, have not been of recent public health importance. However, climate change, migration, changes in health services, antibiotic resistance, population increase, international travel, the increase in the number of immune-depressed patients ,etc have lead to the re-emergence of these diseases. The climate changes are exposing sectors of the population to inadequate fresh air, water, food and resources for survival which, in consequence, provoke increases in both internal and international migration. In this particular period in which we find ourselves, characterized by globalization, the international community has become aware that the re-emergence of these diseases poses an important risk for public health underlines the necessity to adopt appropriate strategies for their prevention and control. The re-emerging diseases of the twenty-first century are a serious problem for public health and even though there has been enormous progress in medical science and in the battle against infectious diseases, they are still a long way from being really brought under control. A well organized monitoring system would enable the epidemiological characteristics of the infectious diseases to be analyzed and the success or otherwise of preventive interventions to be precisely evaluated. For this reason, the World Health Organization and the European Union have discussed the formation of a collaborative network for the monitoring and control of re-emerging diseases and has initiated special programmes. The battle between humanity and infectious disease

  4. Perceived Facilitators and Barriers to Local Health Department Workers' Participation in Infectious Disease Emergency Responses.

    PubMed

    Rutkow, Lainie; Paul, Amy; Taylor, Holly A; Barnett, Daniel J

    Local health departments play a key role in emergency preparedness and respond to a wide range of threats including infectious diseases such as seasonal influenza, tuberculosis, H1N1, Ebola virus disease, and Zika virus disease. To successfully respond to an infectious disease outbreak, local health departments depend upon the participation of their workforce; yet, studies indicate that sizable numbers of workers would not participate in such a response. The reasons why local health department workers participate, or fail to participate, in infectious disease responses are not well understood. To understand why local health department workers are willing, or not willing, to report to work during an infectious disease response. From April 2015 to January 2016, we conducted 28 semistructured interviews with local health department directors, preparedness staff, and nonpreparedness staff. Interviews were conducted with individuals throughout the United States. We interviewed 28 individuals across 3 groups: local health department directors (n = 8), preparedness staff (n = 10), and nonpreparedness staff (n = 10). Individuals' descriptions of why local health department workers are willing, or not willing, to report to work during an infectious disease response. Factors that facilitate willingness to respond to an infectious disease emergency included availability of vaccines and personal protective equipment; flexible work schedule and childcare arrangements; information sharing via local health department trainings; and perceived commitments to one's job and community. Factors that hinder willingness to respond to an infectious disease emergency included potential disease exposure for oneself and one's family; logistical considerations for care of children, the elderly, and pets; and perceptions about one's role during an infectious disease response. Our findings highlight opportunities for local health departments to revisit their internal policies and engage in

  5. [Role of infectious agents in the emergence of malignant tumors].

    PubMed

    Kutikhin, A G; Yuzhalin, A E; Brusina, E B; Briko, N I

    2012-01-01

    According to the data of the International Agency for Research on Cancer (IARC), at least 6 virus species (HPV, EBV, HHV-8/KSHV, HTLV-1, HBV, HCV), 4 helminthes species (Schistosoma haematobium and japonicum, Opisthorchis viverrini, Clonorchis sinensis) and I bacterium species (Helicobacter pylori) have been proved to be capable of causing the development of cancer. The analysis of the data available shows that Merkel cell polyomavirus (MCV), herpes simplex virus (HSV), John Cunningham polyomavirus (JCV), monkey virus 40 (SV40), cytomegalovirus (CMV), xenotropic murine leukemia virus (XMRV), Helicobacter bilis and hepaticus, Campylobacter jejuni, Fusobacterium varium, enteropathogenic Escherichia coli, enterotoxigenic Bacteroides fragilis, Bacteroides vulgatus, Prevotella spp., Streptococcus bovis and anginosus, Treponema denticola, Salmonella typhi, paratyphi and typhimurium, Borrelia burgdorferi, Bartonella spp., Mycobacterium tuberculosis, Chlamydia pneumoniae, trachomatis and psittaci, Neisseria gonorrhoeae, Propionibacterium acnes, Tropheryma whippelii, Schistosoma mansoni, Opistorchis felineus, Strongyloides stercoralis, Taenia solium, Candida spp., Paracoccidioides brasiliensis, Histoplasma capsulatum and Trichomonas vaginalis can also be potential etiological agents of cancer. Apparently, detection of new associations between infectious agents and risk of the development of cancer will facilitate progress in elaboration of prophylaxis measures, early diagnostic methods and, probably, methods of treatment of malignant tumors.

  6. RED Alert – Early warning or detection of global re-emerging infectious disease (RED)

    SciTech Connect

    Deshpande, Alina

    2016-07-13

    This is the PDF of a presentation for a webinar given by Los Alamos National Laboratory (LANL) on the early warning or detection of global re-emerging infectious disease (RED). First, there is an overview of LANL biosurveillance tools. Then, information is given about RED Alert. Next, a demonstration is given of a component prototype. RED Alert is an analysis tool that can provide early warning or detection of the re-emergence of an infectious disease at the global level, but through a local lens.

  7. Diagnosing emerging and reemerging infectious diseases: the pivotal role of the pathologist.

    PubMed

    Olano, Juan P; Walker, David H

    2011-01-01

    Molecular diagnostics continues to evolve very rapidly, and its impact in the diagnosis of infectious diseases is undeniable. Molecular tools have played a pivotal role in discovering and characterizing several emerging infectious agents and have now become the gold standard for the diagnosis of infectious diseases caused by fastidious or uncultivable agents. Multiple challenges still remain for the widespread use of cost-effective, validated, and commercially available molecular tools. Automated instruments capable of sample processing and multiplex nucleic acid amplification and postamplification analysis have already been approved by the US Food and Drug Administration (FDA) for use in the clinical setting. Nanobiotechnology is beginning to impact laboratory diagnostics in the clinical setting. To address current nucleic acid techniques used in the clinical laboratory for diagnosis of infectious diseases. FDA-approved tests are listed, as well as molecular techniques (amplification and postamplification analysis). A comprehensive list of emerging pathogens during the last 4 decades is also presented. Biosurveillance systems are discussed in the context of molecular tools. The rapidly evolving field of nanobiotechnology is briefly addressed. Original publications, major reviews, and book chapters were used to present a comprehensive, yet short, review of molecular diagnostics in infectious diseases. We will continue to witness an exponential growth of molecular techniques used for the initial diagnosis of infectious diseases. Molecular tools will also continue to have an impact on disease prognosis and response to therapeutic interventions. Automation, multiplexing, and miniaturization will continue to be driving forces in the development of new instruments.

  8. Infectious agents of bioterrorism: a review for emergency physicians.

    PubMed

    Kman, Nicholas E; Nelson, Richard N

    2008-05-01

    The terrorist attacks on the United States in 2001 and the anthrax release soon after brought the issue of bioterrorism to the forefront in the medical community. Bioterrorism is the use of a biologic weapon to create terror and panic. Biologic weapons, or bioweapons, can be bacteria, fungi, viruses, or biologic toxins. Because the emergency department represents the front line of defense for the recognition of agents of bioterrorism, it is essential that emergency physicians have the ability to quickly diagnose victims of bioterrorism. This review examines the most deadly and virulent category A agents of bioterrorism, that is, anthrax, smallpox, plague, botulism, hemorrhagic fever viruses, and tularemia. The focus is on epidemiology, transmission, clinical manifestations, diagnosis, and treatment.

  9. Zoonotic emerging infectious disease in selected countries in Southeast Asia: insights from ecohealth.

    PubMed

    Grace, Delia; Gilbert, Jeffrey; Lapar, M Lucila; Unger, Fred; Fèvre, Sonia; Nguyen-Viet, Hung; Schelling, Esther

    2011-03-01

    Most emerging diseases of humans originate in animals, and zoonotic emerging infectious diseases (EIDs) threaten human, animal, and environment health. We report on a scoping study to assess actors, linkages, priorities, and needs related to management of these diseases from the perspective of key stakeholders in three countries in Southeast Asia. A comprehensive interview guide was developed and in-depth interviews completed with 21 key stakeholders in Vietnam, Lao People's Democratic Republic, and Cambodia. We found numerous relevant actors with a predominance of public sector and medical disciplines. More capacity weaknesses than strengths were reported, with risk analysis and research skills most lacking. Social network analysis of information flows showed policy-makers were regarded as mainly information recipients, research institutes as more information providers, and universities as both. Veterinary and livestock disciplines emerged as an important "boundary-spanning" organization with linkages to both human health and rural development. Avian influenza was regarded as the most important zoonotic EID, perhaps reflecting the priority-setting influence of actors outside the region. Stakeholders reported a high awareness of the ecological and socioeconomic drivers of disease emergence and a demand for disease prioritization, epidemiological skills, and economic and qualitative studies. Evaluated from an ecohealth perspective, human health is weakly integrated with socioeconomics, linkages to policy are stronger than to communities, participation occurs mainly at lower levels, and equity considerations are not fully considered. However, stakeholders have awareness of ecological and social determinants of health, and a basis exists on which transdisciplinarity, equity, and participation can be strengthened.

  10. Emergency management logistics must become emergency supply chain management.

    PubMed

    Young, Richard R; Peterson, Matthew R

    2014-01-01

    Much has been written about how emergency management (EM) needs to look to the future regarding issues of resource management (monetary, human, and material). Constraints on budgets are ongoing and the staffing of emergency response activities is often difficult because volunteers have little to no training. The management of material resources has also been a challenge because 1) the categories of material vary by the type of emergency, 2) the necessary quantities of material are often not located near the ultimate point of need, and 3) the transportation assets are rarely available in the form and quantity required to allow timely and effective response. The logistics and resource management functions of EM (what we refer to as EM logistics) have been largely reactive, with little to no pre-event planning for potential demand. We applied the Supply Chain Operational Reference (SCOR) model to EM logistics in an effort to transform it to an integrated and scalable system of physical, information, and financial flows into which are woven the functions of sourcing, making, delivering, and returning, with an overarching planning function that transcends the organizational boundaries of participants. The result is emergency supply chain management, which embraces many more participants who share in a larger quantity of more useful information about the resources that need to be deployed when responding to and recovering from emergency events.

  11. [Present situation and control on emerging respiratory infectious diseases such as SARS and avian influenza].

    PubMed

    Okabe, Nobuhiko

    2005-11-01

    Infectious diseases have been recognized again due to appearing of emerging and re-emerging infectious diseases in the world. Most of them occur not only in developing countries but also in developed countries, and in Asian region. The pathogen is mainly virus and most of them are suspected zoonotic origin. SARS emerged in the world abruptly and disappeared in 2003. We have had many lessons and learn on control measures, public health, economic impacts, human rights, international cooperation and infectious diseases. The outbreaks of avian influenza among fowls have been occurred since 2004, and some fatal human cases infected with avian influenza virus are detected in Viet Nam, Thailand, Cambodia and Indonesia. Although the total number of human cases are still limited and human to human transmission mode is not yet detected, it has been concerned the possibility to shift new types of influenza for human as pandemic. It is necessary to recognize correctly on existing of infectious diseases, to enhance surveillance, to call partnerships among several sectors such as medical institutes, medical education institutes, research institutes and public health departments. Further, infectious disease control should tackle in global level.

  12. Virus like particle-based vaccines against emerging infectious disease viruses.

    PubMed

    Liu, Jinliang; Dai, Shiyu; Wang, Manli; Hu, Zhihong; Wang, Hualin; Deng, Fei

    2016-08-01

    Emerging infectious diseases are major threats to human health. Most severe viral disease outbreaks occur in developing regions where health conditions are poor. With increased international travel and business, the possibility of eventually transmitting infectious viruses between different countries is increasing. The most effective approach in preventing viral diseases is vaccination. However, vaccines are not currently available for numerous viral diseases. Virus-like particles (VLPs) are engineered vaccine candidates that have been studied for decades. VLPs are constructed by viral protein expression in various expression systems that promote the selfassembly of proteins into structures resembling virus particles. VLPs have antigenicity similar to that of the native virus, but are non-infectious as they lack key viral genetic material. VLP vaccines have attracted considerable research interest because they offer several advantages over traditional vaccines. Studies have shown that VLP vaccines can stimulate both humoral and cellular immune responses, which may offer effective antiviral protection. Here we review recent developments with VLP-based vaccines for several highly virulent emerging or re-emerging infectious diseases. The infectious agents discussed include RNA viruses from different virus families, such as the Arenaviridae, Bunyaviridae, Caliciviridae, Coronaviridae, Filoviridae, Flaviviridae, Orthomyxoviridae, Paramyxoviridae, and Togaviridae families.

  13. Emergency Management Standards and Schools

    ERIC Educational Resources Information Center

    National Clearinghouse for Educational Facilities, 2009

    2009-01-01

    This publication discusses emergency management standards for school use and lists standards recommended by FEMA's National Incident Management System (NIMS). Schools are encouraged to review these standards carefully and to adopt, where applicable, those that meet their needs. The lists of standards, resources, and references contained herein…

  14. A disease management case study in infectious disease.

    PubMed

    Wert, S M

    1996-01-01

    One of the earliest attempts at risk sharing between a managed-care organization and a pharmaceutical company is the infectious disease management program developed since late 1993 by Intergroup of Arizona and Eli Lilly and Company (Indianapolis, Indiana) in conjunction with the Center for Pharmaceutical Economics at The University of Arizona (Tucson, Arizona) and other entities. In the first phase of the program, protocols were built around eight infectious disease states, and it was recognized that second-line antibiotics were often prescribed when more economical first-line antibiotics would be equally effective. The second phase of the program emphasized developing treatment algorithms focused on patient outcomes, using merged medical and pharmacy claims databases to determine the effects of the antibiotic changes. To implement the program successfully, some significant shifts in corporate, medical, and patient mind-sets had to be addressed. A primary goal was to encourage a movement from a rebate, volume-driven, cost structure to a shared-risk, appropriate-use, reimbursement method in which both managed-care and the pharmaceutical company incentives could mesh as far as possible. Over the long term, it is hoped that this project will lay the groundwork for other disease management programs for high-impact, frequently occurring diseases.

  15. [Management of intussusception in France in 2004: investigation of the Paediatric Infectious Diseases Group, the French Group of Paediatric Emergency and Reanimation, and the French Society of Paediatric Surgery].

    PubMed

    Grimprel, E; de La Rocque, F; Romain, O; Minodier, P; Dommergues, M-A; Laporte-Turpin, E; Lorrot, M; Parez, N; Caulin, E; Robert, M; Lehors, H; Chéron, G; Levy, C; Haas, H

    2006-12-01

    To describe the different pathways of management of intussusception (IS) in infants and children in metropolitan France and to identify paediatric emergency centres that might constitute a surveillance network for IS. A questionnaire was sent to 273 paediatric emergency centres distributed across France in 2005. Modalities of diagnosis and treatment of IS had to be precised. One hundred and sixty-seven centres (61.2%) responded. The response was given by 131 paediatricians (78.4%) and 36 surgeons (21.6%) working in 38 universitary hospitals (22.7%) and 129 general hospitals (77.2%). The mean number of IS treated in each centre in 2004 was 11+/-13.5 (extr. 0 to 70; median 6). Diagnosis of IS required a collaboration between medical and surgical teams in 51.5% of the centres, but in 40.1% the sole medical team was in charge of the diagnosis. Ultrasonography is used for diagnosis by 98.8% of the centres. Reduction with hydrostatic enema and eventually surgery was performed in the same hospital in 44.3%. Other centres systematically or frequently transferred the patients for reduction, mostly towards universitary hospitals (90%). The procedures of IS diagnosis are the same everywhere in France but the pathways of therapeutic management do vary, depending on the availability of surgeons and anaesthetists trained in paediatrics on each site. These disparities will probably change with the implementation of the new plan for sanitary organization in children and adolescents in France. Labellized paediatric emergency centres will gather more surgical patients and could eventually constitute an effective surveillance network for IS.

  16. Infectious disease in cervids of North America: data, models, and management challenges.

    PubMed

    Conner, Mary Margaret; Ebinger, Michael Ryan; Blanchong, Julie Anne; Cross, Paul Chafee

    2008-01-01

    Over the past two decades there has been a steady increase in the study and management of wildlife diseases. This trend has been driven by the perception of an increase in emerging zoonotic diseases and the recognition that wildlife can be a critical factor for controlling infectious diseases in domestic animals. Cervids are of recent concern because, as a group, they present a number of unique challenges. Their close ecological and phylogenetic relationship to livestock species places them at risk for receiving infections from, and reinfecting livestock. In addition, cervids are an important resource; revenue from hunting and viewing contribute substantially to agency budgets and local economies. A comprehensive coverage of infectious diseases in cervids is well beyond the scope of this chapter. In North America alone there are a number of infectious diseases that can potentially impact cervid populations, but for most of these, management is not feasible or the diseases are only a potential or future concern. We focus this chapter on three diseases that are of major management concern and the center of most disease research for cervids in North America: bovine tuberculosis, chronic wasting disease, and brucellosis. We discuss the available data and recent advances in modeling and management of these diseases.

  17. Understanding an Ebola outbreak: Social representations of emerging infectious diseases.

    PubMed

    Idoiaga Mondragon, Nahia; Gil de Montes, Lorena; Valencia, Jose

    2016-01-07

    This study examined the collective image of the 2014-2015 Ebola outbreak, to understand how people incorporate this epidemic in their everyday thinking. A free association exercise elicited by Ebola was answered by 294 people from Spain and the content was analysed using Alceste software. First, results showed that Ebola was represented as inherently African. Second, it was also depicted as a global threat creating fear. People also felt anger, and they blamed political authorities and the mass media for the failure to manage this crisis. Finally, this research underlines the importance of the social representations to understand how current outbreaks are cognitively represented and emotionally faced as a key factor to appropriately manage future epidemics.

  18. Is there a link between pollutant exposure and emerging infectious disease?

    PubMed Central

    Hodges, Elizabeth; Tomcej, Veronica

    2016-01-01

    A scoping literature review found evidence supporting the hypothesis that a population’s pollution status could help refine classification of emerging infectious disease (EID) hotspots. Systematic literature reviews and studies designed to specifically test the predictive value of pollutant status on EID risk are recommended. PMID:27152044

  19. The emerging infectious disease crisis and pathogen pollution: a question of ecology and evolution

    USDA-ARS?s Scientific Manuscript database

    Risk of emerging infectious diseases (EID) on a global scale has accelerated over the past 10,000 years in conjunction with agriculture, domestication, and globalization as the interfaces for people and environments have been altered over time. EID exist at the junction of 3 ongoing global challenge...

  20. Emergency management of alveolar osteitis.

    PubMed

    Summers, Anthony

    2011-12-01

    Patients with urgent dental problems who present to emergency departments (EDs) during weekday office hours are usually referred to their dentists, often after being provided with analgesia. Outside these hours, however, ED professionals may have to provide treatment before referral. One dental emergency with which patients may present but of which ED staff are unlikely to have experience is alveolar osteitis, a painful condition that occurs usually after tooth extraction. This article defines alveolar osteitis and describes management in an ED.

  1. Emergency management: An annotated bibliography

    SciTech Connect

    Not Available

    1988-03-01

    Training Resources and Data Exchange (TRADE) is an organization designed to increase communication and exchange of ideas, information, and resources among US Department of Energy contractors and DOE personnel. Oak Ridge Associated Universities, located in Oak Ridge, Tennessee, manages TRADE for the DOE. The Emergency Preparedness Special Interest Group (EP SIG) is a group formed within TRADE for emergency preparedness coordinators and trainers to share information about emergency preparedness training and other EP resources. This bibliography was prepared for the EP SIG as a resource for EP training and planning activities.

  2. Emergency management of head injuries.

    PubMed

    Rimel, R W; Jane, J A; Tyson, G W

    1981-03-01

    Sophisticated care of the head injury patient in the emergency department does not demand sophisticated knowledge of neurosurgery. Instead it depends upon: (1) Meticulous attention to the fundamental principles of resuscitation; (B) Prevention of secondary cardiopulmonary abnormalities which can further injure the traumatized brain; (C) Performance of serial neurologic examinations. (In the case of acute head injury, a simple neurologic examination performed repeatedly usually provides the physician with more useful information than a more elaborate examination performed only once). (D) Consultation with the neurosurgeon. If there is any possibility that neurosurgical consultation might enhance the emergency department management of the patient, one should not hesitate to contact him. There is no question that protocols for any phase of emergency management of central nervous system (CNA) trauma are of no values unless there is a high degree of compliance. This can only be achieved through persons dedicated to training emergency medical technicians, nurses and physicians in the optimal care that can be afforded these patients. If advances are to be made in decreasing the morbidity and mortality of the CNS trauma patient, those actively involved in emergency medicine are going to have to take an active role in training programs, seminars and clinical practice for physicians, emergency department nurses, and emergency medical technicians.

  3. Infectious causes of microcephaly: epidemiology, pathogenesis, diagnosis, and management.

    PubMed

    Devakumar, Delan; Bamford, Alasdair; Ferreira, Marcelo U; Broad, Jonathan; Rosch, Richard E; Groce, Nora; Breuer, Judith; Cardoso, Marly A; Copp, Andrew J; Alexandre, Paula; Rodrigues, Laura C; Abubakar, Ibrahim

    2017-08-22

    Microcephaly is an important sign of neurological malformation and a predictor of future disability. The 2015-16 outbreak of Zika virus and congenital Zika infection brought the world's attention to links between Zika infection and microcephaly. However, Zika virus is only one of the infectious causes of microcephaly and, although the contexts in which they occur vary greatly, all are of concern. In this Review, we summarise important aspects of major congenital infections that can cause microcephaly, and describe the epidemiology, transmission, clinical features, pathogenesis, management, and long-term consequences of these infections. We include infections that cause substantial impairment: cytomegalovirus, herpes simplex virus, rubella virus, Toxoplasma gondii, and Zika virus. We highlight potential issues with classification of microcephaly and show how some infants affected by congenital infection might be missed or incorrectly diagnosed. Although Zika virus has brought the attention of the world to the problem of microcephaly, prevention of all infectious causes of microcephaly and appropriately managing its consequences remain important global public health priorities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Management of infectious intracranial aneurysms in the pediatric population.

    PubMed

    Flores, Bruno C; Patel, Ankur R; Braga, Bruno P; Weprin, Bradley E; Batjer, H Hunt

    2016-07-01

    Infectious intracranial aneurysms (IIAs) account for approximately 15 % of all pediatric intracranial aneurysms. Histologically, they are pseudoaneurysms that develop in response to an inflammatory reaction within the adventitia and muscularis layers, ultimately resulting in disruption of both the internal elastic membrane and the intima. The majority of pediatric IIAs are located within the anterior circulation, and they can be multiple in 15-25 % of cases. The most common presentation for an IIA is intracerebral and/or subarachnoid hemorrhage. In children with a known diagnosis of infective endocarditis who develop new neurological manifestations, it is imperative to exclude the existence of an IIA. The natural history of untreated infectious aneurysms is ominous; they demonstrate a high incidence of spontaneous rupture. High clinical suspicion, prompt diagnosis, and adequate treatment are of paramount importance to prevent devastating neurological consequences. The prompt initiation of intravenous broad-spectrum antibiotics represents the mainstay of treatment. Three questions should guide the management of pediatric patients with IIAs: (a) aneurysm rupture status, (b) the presence of intraparenchymal hemorrhage or elevated intracranial pressure, and (c) relationship of the parent vessel to eloquent brain tissue. Those three questions should orient the treating physician into either antibiotic therapy alone or in combination with microsurgical or endovascular interventions. This review discusses important aspects of the epidemiology, the diagnosis, and the management of IIAs in the pediatric population.

  5. Unhealthy landscapes: Policy recommendations on land use change and infectious disease emergence.

    PubMed

    Patz, Jonathan A; Daszak, Peter; Tabor, Gary M; Aguirre, A Alonso; Pearl, Mary; Epstein, Jon; Wolfe, Nathan D; Kilpatrick, A Marm; Foufopoulos, Johannes; Molyneux, David; Bradley, David J

    2004-07-01

    Anthropogenic land use changes drive a range of infectious disease outbreaks and emergence events and modify the transmission of endemic infections. These drivers include agricultural encroachment, deforestation, road construction, dam building, irrigation, wetland modification, mining, the concentration or expansion of urban environments, coastal zone degradation, and other activities. These changes in turn cause a cascade of factors that exacerbate infectious disease emergence, such as forest fragmentation, disease introduction, pollution, poverty, and human migration. The Working Group on Land Use Change and Disease Emergence grew out of a special colloquium that convened international experts in infectious diseases, ecology, and environmental health to assess the current state of knowledge and to develop recommendations for addressing these environmental health challenges. The group established a systems model approach and priority lists of infectious diseases affected by ecologic degradation. Policy-relevant levels of the model include specific health risk factors, landscape or habitat change, and institutional (economic and behavioral) levels. The group recommended creating Centers of Excellence in Ecology and Health Research and Training, based at regional universities and/or research institutes with close links to the surrounding communities. The centers' objectives would be 3-fold: a) to provide information to local communities about the links between environmental change and public health; b) to facilitate fully interdisciplinary research from a variety of natural, social, and health sciences and train professionals who can conduct interdisciplinary research; and c) to engage in science-based communication and assessment for policy making toward sustainable health and ecosystems.

  6. Unhealthy Landscapes: Policy Recommendations on Land Use Change and Infectious Disease Emergence

    PubMed Central

    Patz, Jonathan A.; Daszak, Peter; Tabor, Gary M.; Aguirre, A. Alonso; Pearl, Mary; Epstein, Jon; Wolfe, Nathan D.; Kilpatrick, A. Marm; Foufopoulos, Johannes; Molyneux, David; Bradley, David J.

    2004-01-01

    Anthropogenic land use changes drive a range of infectious disease outbreaks and emergence events and modify the transmission of endemic infections. These drivers include agricultural encroachment, deforestation, road construction, dam building, irrigation, wetland modification, mining, the concentration or expansion of urban environments, coastal zone degradation, and other activities. These changes in turn cause a cascade of factors that exacerbate infectious disease emergence, such as forest fragmentation, disease introduction, pollution, poverty, and human migration. The Working Group on Land Use Change and Disease Emergence grew out of a special colloquium that convened international experts in infectious diseases, ecology, and environmental health to assess the current state of knowledge and to develop recommendations for addressing these environmental health challenges. The group established a systems model approach and priority lists of infectious diseases affected by ecologic degradation. Policy-relevant levels of the model include specific health risk factors, landscape or habitat change, and institutional (economic and behavioral) levels. The group recommended creating Centers of Excellence in Ecology and Health Research and Training, based at regional universities and/or research institutes with close links to the surrounding communities. The centers’ objectives would be 3-fold: a) to provide information to local communities about the links between environmental change and public health; b) to facilitate fully interdisciplinary research from a variety of natural, social, and health sciences and train professionals who can conduct interdisciplinary research; and c) to engage in science-based communication and assessment for policy making toward sustainable health and ecosystems. PMID:15238283

  7. Landscape epidemiology of emerging infectious diseases in natural and human-altered ecosystems.

    PubMed

    Meentemeyer, Ross K; Haas, Sarah E; Václavík, Tomáš

    2012-01-01

    A central challenge to studying emerging infectious diseases (EIDs) is a landscape dilemma: Our best empirical understanding of disease dynamics occurs at local scales, whereas pathogen invasions and management occur over broad spatial extents. The burgeoning field of landscape epidemiology integrates concepts and approaches from disease ecology with the macroscale lens of landscape ecology, enabling examination of disease across spatiotemporal scales in complex environmental settings. We review the state of the field and describe analytical frontiers that show promise for advancement, focusing on natural and human-altered ecosystems. Concepts fundamental to practicing landscape epidemiology are discussed, including spatial scale, static versus dynamic modeling, spatially implicit versus explicit approaches, selection of ecologically meaningful variables, and inference versus prediction. We highlight studies that have advanced the field by incorporating multiscale analyses, landscape connectivity, and dynamic modeling. Future research directions include understanding disease as a component of interacting ecological disturbances, scaling up the ecological impacts of disease, and examining disease dynamics as a coupled human-natural system.

  8. Management of neutropenic patients in the intensive care unit (NEWBORNS EXCLUDED) recommendations from an expert panel from the French Intensive Care Society (SRLF) with the French Group for Pediatric Intensive Care Emergencies (GFRUP), the French Society of Anesthesia and Intensive Care (SFAR), the French Society of Hematology (SFH), the French Society for Hospital Hygiene (SF2H), and the French Infectious Diseases Society (SPILF).

    PubMed

    Schnell, David; Azoulay, Elie; Benoit, Dominique; Clouzeau, Benjamin; Demaret, Pierre; Ducassou, Stéphane; Frange, Pierre; Lafaurie, Matthieu; Legrand, Matthieu; Meert, Anne-Pascale; Mokart, Djamel; Naudin, Jérôme; Pene, Frédéric; Rabbat, Antoine; Raffoux, Emmanuel; Ribaud, Patricia; Richard, Jean-Christophe; Vincent, François; Zahar, Jean-Ralph; Darmon, Michael

    2016-12-01

    Neutropenia is defined by either an absolute or functional defect (acute myeloid leukemia or myelodysplastic syndrome) of polymorphonuclear neutrophils and is associated with high risk of specific complications that may require intensive care unit (ICU) admission. Specificities in the management of critically ill neutropenic patients prompted the establishment of guidelines dedicated to intensivists. These recommendations were drawn up by a panel of experts brought together by the French Intensive Care Society in collaboration with the French Group for Pediatric Intensive Care Emergencies, the French Society of Anesthesia and Intensive Care, the French Society of Hematology, the French Society for Hospital Hygiene, and the French Infectious Diseases Society. Literature review and formulation of recommendations were performed using the Grading of Recommendations Assessment, Development and Evaluation system. Each recommendation was then evaluated and rated by each expert using a methodology derived from the RAND/UCLA Appropriateness Method. Six fields are covered by the provided recommendations: (1) ICU admission and prognosis, (2) protective isolation and prophylaxis, (3) management of acute respiratory failure, (4) organ failure and organ support, (5) antibiotic management and source control, and (6) hematological management. Most of the provided recommendations are obtained from low levels of evidence, however, suggesting a need for additional studies. Seven recommendations were, however, associated with high level of evidences and are related to protective isolation, diagnostic workup of acute respiratory failure, medical management, and timing surgery in patients with typhlitis.

  9. Emerging infectious diseases in an island ecosystem: the New Zealand perspective.

    PubMed Central

    Crump, J. A.; Murdoch, D. R.; Baker, M. G.

    2001-01-01

    Several unique features characterize infectious disease epidemiology in New Zealand. Historically, well-organized, government-run control programs have eliminated several zoonoses. More recently, however, communicable disease control has been mixed. Rates of rheumatic fever, tuberculosis, and enteric infectious are high, and rates of meningococcal disease are increasing. These diseases are over-represented in New Zealanders of Polynesian descent, who generally live in more deprived and overcrowded conditions than do those of European descent. Measles and pertussis epidemics are recurring because of inadequate vaccine coverage, despite a well-developed childhood immunization program. A progressive response to the HIV epidemic has resulted in relatively low rates of infection, particularly among injecting drug users; however, the response to other sexually transmitted infections has been poor. A key challenge for the future is to build on successful strategies and apply them to persisting and emerging infectious disease threats in a small, geographically isolated country with limited economic resources. PMID:11747690

  10. Biosecurity measures in 48 isolation facilities managing highly infectious diseases.

    PubMed

    Puro, Vincenzo; Fusco, Francesco M; Schilling, Stefan; Thomson, Gail; De Iaco, Giuseppina; Brouqui, Philippe; Maltezou, Helena C; Bannister, Barbara; Gottschalk, René; Brodt, Hans-Rheinhard; Ippolito, Giuseppe

    2012-06-01

    Biosecurity measures are traditionally applied to laboratories, but they may also be usefully applied in highly specialized clinical settings, such as the isolation facilities for the management of patients with highly infectious diseases (eg, viral hemorrhagic fevers, SARS, smallpox, potentially severe pandemic flu, and MDR- and XDR-tuberculosis). In 2009 the European Network for Highly Infectious Diseases conducted a survey in 48 isolation facilities in 16 European countries to determine biosecurity measures for access control to the facility. Security personnel are present in 39 facilities (81%). In 35 facilities (73%), entrance to the isolation area is restricted; control methods include electronic keys, a PIN system, closed-circuit TV, and guards at the doors. In 25 facilities (52%), identification and registration of all staff entering and exiting the isolation area are required. Access control is used in most surveyed centers, but specific lacks exist in some facilities. Further data are needed to assess other biosecurity aspects, such as the security measures during the transportation of potentially contaminated materials and measures to address the risk of an "insider attack."

  11. Biosecurity Measures in 48 Isolation Facilities Managing Highly Infectious Diseases

    PubMed Central

    Puro, Vincenzo; Schilling, Stefan; Thomson, Gail; De Iaco, Giuseppina; Brouqui, Philippe; Maltezou, Helena C.; Bannister, Barbara; Gottschalk, René; Brodt, Hans-Rheinhard; Ippolito, Giuseppe

    2012-01-01

    Biosecurity measures are traditionally applied to laboratories, but they may also be usefully applied in highly specialized clinical settings, such as the isolation facilities for the management of patients with highly infectious diseases (eg, viral hemorrhagic fevers, SARS, smallpox, potentially severe pandemic flu, and MDR- and XDR-tuberculosis). In 2009 the European Network for Highly Infectious Diseases conducted a survey in 48 isolation facilities in 16 European countries to determine biosecurity measures for access control to the facility. Security personnel are present in 39 facilities (81%). In 35 facilities (73%), entrance to the isolation area is restricted; control methods include electronic keys, a PIN system, closed-circuit TV, and guards at the doors. In 25 facilities (52%), identification and registration of all staff entering and exiting the isolation area are required. Access control is used in most surveyed centers, but specific lacks exist in some facilities. Further data are needed to assess other biosecurity aspects, such as the security measures during the transportation of potentially contaminated materials and measures to address the risk of an “insider attack.” PMID:22571373

  12. [Emerging infectious diseases: the example of the Indian Ocean chikungunya outbreak (2005-2006)].

    PubMed

    Flahault, Antoine

    2007-01-01

    Factors known to trigger the emergence or re-emergence of infectious diseases include globalisation, population growth, migration, international trade, urbanisation, forest destruction, climate change, loss of biodiversity, poverty, famine and war. Epidemics not only lead to disastrous loss of human life but may also have catastrophic economic, political and social consequences. Outbreaks may rapidly jeopardize industry, trade or tourism in countries that are unprepared. Dengue is currently spreading throughout the tropics, while another arbovirus, chikungunya, infected 30 to 75% of the population in some parts of the Indian Ocean region between 2005 and 2006. Chikungunya is now spreading through India, where more than a million people have so far been infected. This viral disease can cause lasting disability, and the first deaths were recently reported in La Réunion and Mayotte. All countries are at risk from emerging or re-emerging diseases, but the consequences are far worse in poor countries. Microbial pathogens and wild mammals, birds and arthropods do not respect man-made borders. There is still time to act against this threat of emerging and re-emerging infectious diseases, through prevention, anticipation, monitoring and research.

  13. Sustaining a regional emerging infectious disease research network: a trust-based approach.

    PubMed

    Silkavute, Pornpit; Tung, Dinh Xuan; Jongudomsuk, Pongpisut

    2013-01-01

    The Asia Partnership on Emerging Infectious Diseases Research (APEIR) was initiated in 2006 to promote regional collaboration in avian influenza research. In 2009, the partnership expanded its scope to include all emerging infectious diseases. APEIR partners include public health and animal researchers, officials and practitioners from Cambodia, China, Lao PDR, Indonesia, Thailand and Vietnam. APEIR has accomplished several major achievements in three key areas of activity: (i) knowledge generation (i.e., through research); (ii) research capacity building (e.g., by developing high-quality research proposals, by planning and conducting joint research projects, by adopting a broader Ecohealth/OneHealth approach); and (iii) policy advocacy (e.g., by disseminating research results to policy makers). This paper describes these achievements, with a focus on the partnership's five major areas of emerging infectious disease research: wild migratory birds, backyard poultry systems, socio-economic impact, policy analysis, and control measures. We highlight two case studies illustrating how the partnership's research results are being used to inform policy. We also highlight lessons learned after five years of working hard to build our partnership and the value added by a multi-country, multi-sectoral, multi-disciplinary research partnership like APEIR.

  14. Sustaining a Regional Emerging Infectious Disease Research Network: A Trust-Based Approach

    PubMed Central

    Silkavute, Pornpit; Tung, Dinh Xuan; Jongudomsuk, Pongpisut

    2013-01-01

    The Asia Partnership on Emerging Infectious Diseases Research (APEIR) was initiated in 2006 to promote regional collaboration in avian influenza research. In 2009, the partnership expanded its scope to include all emerging infectious diseases. APEIR partners include public health and animal researchers, officials and practitioners from Cambodia, China, Lao PDR, Indonesia, Thailand and Vietnam. APEIR has accomplished several major achievements in three key areas of activity: (i) knowledge generation (i.e., through research); (ii) research capacity building (e.g., by developing high-quality research proposals, by planning and conducting joint research projects, by adopting a broader Ecohealth/OneHealth approach); and (iii) policy advocacy (e.g., by disseminating research results to policy makers). This paper describes these achievements, with a focus on the partnership's five major areas of emerging infectious disease research: wild migratory birds, backyard poultry systems, socio-economic impact, policy analysis, and control measures. We highlight two case studies illustrating how the partnership's research results are being used to inform policy. We also highlight lessons learned after five years of working hard to build our partnership and the value added by a multi-country, multi-sectoral, multi-disciplinary research partnership like APEIR. PMID:23362419

  15. Nurses' intentions to respond to bioterrorism and other infectious disease emergencies.

    PubMed

    Grimes, Deanna E; Mendias, Elnora P

    2010-01-01

    Although nurses historically have responded to natural disasters, little is known about nurses' intentions to respond during bioterrorism and other infectious disease emergencies where they and their families may be at risk. To investigate that question, we surveyed nurses following their participation in a class on bioterrorism. Participants (N = 292) completed a Personal/Professional Profile (PPP), Test of Bioterrorism Knowledge (BT Knowledge), and an Intention to Respond (IR) instrument. IR was measured by participants' scores on their likelihood to care for patients (0 = extremely unlikely, 10 = extremely likely) for each of 10 infectious disease scenarios reflecting different infection risk. We calculated scores for each scenario, totaled them, and examined the total IR related to the participant's PPP and scores on BT Knowledge. Additionally, we examined participants' written comments explaining the reasons for their IR. Total IR scores ranged from 8-100 (mean and median of 70). The IR was higher in scenarios where the infection risk was lower. Overall IR scores were positively related to BT Knowledge and having had previous emergency and disaster experience. Those less likely to respond had dependent children and more years in nursing. Results indicate that nurses differentiated risks associated with different infectious disease situations and may decide to respond during a real emergency based on such information. Implications for nursing administrators and nursing educators are discussed. Copyright 2010 Mosby, Inc. All rights reserved.

  16. Infectious disease emergence and global change: thinking systemically in a shrinking world

    PubMed Central

    2012-01-01

    Background Concern intensifying that emerging infectious diseases and global environmental changes that could generate major future human pandemics. Method A focused literature review was undertaken, partly informed by a forthcoming report on environment, agriculture and infectious diseases of poverty, facilitated by the Special Programme for Tropical Diseases. Results More than ten categories of infectious disease emergence exist, but none formally analyse past, current or future burden of disease. Other evidence suggests that the dominant public health concern focuses on two informal groupings. Most important is the perceived threat of newly recognised infections, especially viruses that arise or are newly discovered in developing countries that originate in species exotic to developed countries, such as non-human primates, bats and rodents. These pathogens may be transmitted by insects or bats, or via direct human contact with bushmeat. The second group is new strains of influenza arising from intensively farmed chickens or pigs, or emerging from Asian “wet markets” where several bird species have close contact. Both forms appear justified because of two great pandemics: HIV/AIDS (which appears to have originated from bushmeat hunting in Africa before emerging globally) and Spanish influenza, which killed up to 2.5% of the human population around the end of World War I. Insufficiently appreciated is the contribution of the milieu which appeared to facilitate the high disease burden in these pandemics. Additionally, excess anxiety over emerging infectious diseases diverts attention from issues of greater public health importance, especially: (i) existing (including neglected) infectious diseases and (ii) the changing milieu that is eroding the determinants of immunity and public health, caused by adverse global environmental changes, including climate change and other components of stressed life and civilisation-supporting systems. Conclusions The focus on

  17. Quantifying effectiveness in emergency management.

    PubMed

    Weaver, John Michael

    2014-01-01

    This study looked at the relationship between the Departments of Defense (DOD) and Homeland Security (DHS). Moreover, it reviewed the interface between their two subordinate organizations (Northern Command under DOD and the Federal Emergency Management Agency under DHS) with primacy over domestic disasters. Understanding the importance of intergovernmental relations (IGRs), the article dissected the interrelatedness of these organizations regarding hurricanes and the subsequent involvement of federal preparation and response efforts. The informal networked relationships were evaluated using regression analysis focusing on secondary sources of data and several variables. The vitality of collaborative networks is grounded in literature and has been espoused by Waugh and Streib in the world of emergency management; this study expanded on their premise.

  18. Pediatric Ingestions: Emergency Department Management.

    PubMed

    Tarango Md, Stacy M; Liu Md, Deborah R

    2016-04-01

    Pediatric ingestions present a common challenge for emergency clinicians. Each year, more than 50,000 children aged less than 5 years present to emergency departments with concern for unintentional medication exposure, and nearly half of all calls to poison centers are for children aged less than 6 years. Ingestion of magnetic objects and button batteries has also become an increasing source of morbidity and mortality. Although fatal pediatric ingestions are rare, the prescription medications most responsible for injury and fatality in children include opioids, sedative/hypnotics, and cardiovascular drugs. Evidence regarding the evaluation and management of common pediatric ingestions is comprised largely of case reports and retrospective studies. This issue provides a review of these studies as well as consensus guidelines addressing the initial resuscitation, diagnosis, and treatment of common pediatric ingestions. Also discussed are current recommendations for decontamination, administration of antidotes for specific toxins, and management of ingested foreign bodies.

  19. Airway management in emergency situations.

    PubMed

    Dörges, Volker

    2005-12-01

    Securing and monitoring the airway are among the key requirements of appropriate therapy in emergency patients. Failures to secure the airways can drastically increase morbidity and mortality of patients within a very short time. Therefore, the entire range of measures needed to secure the airway in an emergency, without intermediate ventilation and oxygenation, is limited to 30-40 seconds. Endotracheal intubation is often called the 'gold standard' for airway management in an emergency, but multiple failed intubation attempts do not result in maintaining oxygenation; instead, they endanger the patient by prolonging hypoxia and causing additional trauma to the upper airways. Thus, knowledge and availability of alternative procedures are also essential in every emergency setting. Given the great variety of techniques available, it is important to establish a well-planned, methodical protocol within the framework of an algorithm. This not only facilitates the preparation of equipment and the training of personnel, it also ensures efficient decision-making under time pressure. Most anaesthesia-related deaths are due to hypoxaemia when difficulty in securing the airway is encountered, especially in obstetrics during induction of anaesthesia for caesarean delivery. The most commonly occurring adverse respiratory events are failure to intubate, failure to recognize oesophageal intubation, and failure to ventilate. Thus, it is essential that every anaesthesiologist working on the labour and delivery ward is comfortable with the algorithm for the management of failed intubation. The algorithm for emergency airway management describing the sequence of various procedures has to be adapted to internal standards and to techniques that are available.

  20. Global climate change and the emergence/re-emergence of infectious diseases.

    PubMed

    Zell, Roland

    2004-04-01

    Variation in the incidence of vector-borne diseases is associated with extreme weather events and annual changes in weather conditions. Moreover, it is assumed that global warming might lead to an increase of infectious disease outbreaks. While a number of reports link disease outbreaks to single weather events, the El Niño/Southern Oscillation and other large-scale climate fluctuations, no report unequivocally associates vector-borne diseases with increased temperature and the environmental changes expected to accompany it. The complexity of not yet fully understood pathogen transmission dynamics with numerous variables might be an explanation of the problems in assessing the risk factors.

  1. [Advance in application of syndromic surveillance for detection of emerging infectious diseases and outbreak alerts].

    PubMed

    Lin, Mei; Wang, Xin; Liang, Dabin

    2015-07-01

    Over the past decade, syndromic surveillance, as supplementation of disease surveillance, has provided possibility of early alert in a real-time way for detection of emerging infectious diseases and outbreaks of widespread infectious diseases, resulting in improvement in sensitivity of outbreak detection and public health alert capacity. This tool has been highly valued and widely used in the world, and effective implementation has been observed in China. Upon abundant literature search, the authors reviewed the progress and advance of syndromic surveillance in early alert of emerging infectious diseases and outbreaks, and analyzed the problem met in the current situation in China when implementing syndromic surveillance in local facilities, which are high cost, lack of medical information platform, lack of real-time digital alert system and lack of a comprehensive information exchange platform. The authors suggested that syndromic surveillance should be implemented considering the local situation and performed in a more effective way in the current situation. Syndromic surveillance has to be integrated into the conventional public health surveillance systems and advanced laboratory networks. Digital information system is urgently needed to achieve real-time alert.

  2. Management of gynecologic oncology emergencies

    SciTech Connect

    Harwood-Nuss, A.L.; Benrubi, G.I.; Nuss, R.C.

    1987-08-01

    Gynecologic malignancies are the third most common cancer among women in the United States. Because of often subtle early findings, the diagnosis may not be made before the widespread dissemination of the disease. The Emergency Department physician will commonly encounter a woman with vaginal bleeding, pelvic pain, or a symptomatic abdominal mass. In this article, we have described the epidemiology, recognized patterns of spread, and associated findings of gynecologic tumors. The proper Emergency Department evaluation and management of these problems is emphasized with guidelines for the timing of referrals and consultation with the gynecologic oncologist. The treatment of gynecologic malignancies is often complicated and responsible for Emergency Department visits. The various modalities are addressed according to the organ systems affected and include sections on postoperative problems, gastrointestinal complaints, urologic complications of therapy, radiation therapy and its complications, with an emphasis on the most serious complications necessitating either careful outpatient management or hospital admission. As cost-containment pressure grows, we have included sections on chemotherapy and total parenteral nutrition, both of which are becoming common outpatient events for the cancer patient. 28 references.

  3. Emergency Management: A National Perspective. 3

    DTIC Science & Technology

    1989-06-01

    FEDERAL EMERGENCY MANAGEMENT AGENCY BII u COPYIutI LO Emergency Management A National Perspective III .+,..D TIC ELECTEUAUS2?1-,D{@ ~ !?~~nNSTVMN A...OOZ . . .. . . . = , .. ,= .. by Keith F. Mulrooney Prepared under contract from The Federal Emergency Management Agency by Graham W. Watt & Associates...Fort Lauderdale, Florida June 1989 This is another in a series of monographs on the subject of emergency management. The purpose of this series is to

  4. Bleeding varices: 1. Emergency management.

    PubMed Central

    Hanna, S S; Warren, W D; Galambos, J T; Millikan, W J

    1981-01-01

    The aim of the emergency management of bleeding varices is to stop the hemorrhage nonoperatively if possible, avoiding emergency shunt surgery, an operation that has a higher mortality than elective shunt surgery. Patients with an upper gastrointestinal hemorrhage should undergo endoscopy immediately to verify the diagnosis of bleeding varices. They can then be categorized according to whether they stop bleeding spontaneously (group 1), continue to bleed slowly (group 2) or continue to bleed rapidly (group 3). Group 1 patients are discussed in the second part of this two-part series. Group 2 patients are initially treated with vasopressin given intravenously; those who fail to respond should undergo emergency angiography and receive vasopressin intra-arterially. If this fails, patients at low surgical risk should undergo urgent shunt surgery; those at high risk do better with endoscopic sclerotherapy. Group 3 patients are also given an intravenous infusion of vasopressin. Patients at low surgical risk who continue to bleed then receive tamponade with a Sengstaken--Blakemore tube. If this fails, they undergo emergency creation of an H-shaped mesocaval shunt. Patients at high surgical risk who fail to respond to vasopressin given intravenously are next treated intra-arterially. If this fails they are given either endoscopic or transhepatic sclerotherapy. PMID:7006779

  5. Emerging infectious disease and the loss of biodiversity in a Neotropical amphibian community

    PubMed Central

    Lips, Karen R.; Brem, Forrest; Brenes, Roberto; Reeve, John D.; Alford, Ross A.; Voyles, Jamie; Carey, Cynthia; Livo, Lauren; Pessier, Allan P.; Collins, James P.

    2006-01-01

    Pathogens rarely cause extinctions of host species, and there are few examples of a pathogen changing species richness and diversity of an ecological community by causing local extinctions across a wide range of species. We report the link between the rapid appearance of a pathogenic chytrid fungus Batrachochytrium dendrobatidis in an amphibian community at El Copé, Panama, and subsequent mass mortality and loss of amphibian biodiversity across eight families of frogs and salamanders. We describe an outbreak of chytridiomycosis in Panama and argue that this infectious disease has played an important role in amphibian population declines. The high virulence and large number of potential hosts of this emerging infectious disease threaten global amphibian diversity. PMID:16481617

  6. The Key Role of Genomics in Modern Vaccine and Drug Design for Emerging Infectious Diseases

    PubMed Central

    Seib, Kate L.; Dougan, Gordon; Rappuoli, Rino

    2009-01-01

    It can be argued that the arrival of the “genomics era” has significantly shifted the paradigm of vaccine and therapeutics development from microbiological to sequence-based approaches. Genome sequences provide a previously unattainable route to investigate the mechanisms that underpin pathogenesis. Genomics, transcriptomics, metabolomics, structural genomics, proteomics, and immunomics are being exploited to perfect the identification of targets, to design new vaccines and drugs, and to predict their effects in patients. Furthermore, human genomics and related studies are providing insights into aspects of host biology that are important in infectious disease. This ever-growing body of genomic data and new genome-based approaches will play a critical role in the future to enable timely development of vaccines and therapeutics to control emerging infectious diseases. PMID:19855822

  7. Managing hypopituitarism in emergency departments.

    PubMed

    Welsh, Jeanette

    2015-10-01

    Healthcare professionals manage patients with a vast range of conditions, but often specialise and acquire expertise in specific disease processes. Emergency and pre-hospital clinicians care for patients with various conditions for short periods of time, so have less opportunity to become familiar with more unusual conditions, yet it is vital that they have some knowledge and understanding of these. Patients with rare conditions can present at emergency departments with common complaints, but the effect of their original diagnosis on the presenting complaint may be overlooked or underestimated. This article uses a case study to describe the experience of one patient who presented with vomiting, but who also had hypopituitarism and therefore required specific management she did not at first receive. The article describes hypopituitarism and the initial management of patients with this condition who become unwell, and discusses how the trust responded to the patient's complaint to improve patient safety and care. It has been written with the full participation and consent of the patient and her husband.

  8. Hypertensive emergencies. Etiology and management.

    PubMed

    Tuncel, Meryem; Ram, Venkata C S

    2003-01-01

    Although systemic hypertension is a common clinical disorder, hypertensive emergencies are unusual in clinical practice. Situations that qualify as hypertensive emergencies include accelerated or malignant hypertension, hypertensive encephalopathy, acute left ventricular failure, acute aortic dissection, pheochromocytoma crisis, interaction between tyramine-containing foods or drugs and monoamine oxidase inhibitors, eclampsia, drug-induced hypertension and possibly intracranial hemorrhage. It is important to recognize these conditions since immediate lowering of systemic blood pressure is indicated. The diagnosis of hypertensive emergencies depends on the clinical manifestations rather than on the absolute level of the blood pressure. Depending on the target organ that is affected, the manifestations of hypertensive emergencies can be quite expressive, yet variable. Thus, the physician has to make the clinical diagnosis urgently in order to render appropriate therapy. Several parenteral drugs can quickly and effectively lower the blood pressure in hypertensive emergencies. Intravenous fenoldopam, a selective dopamine (DA1) receptor agonist, offers the advantage of improving renal blood flow and causing natriuresis. Intravenous nicardipine may be beneficial in reserving tissue perfusion in patients with ischemic disorders. Whereas trimethaphan camsilate is the drug of choice for managing acute aortic dissection, hydralazine remains the drug of choice for the treatment of eclampsia. The alpha-adrenoceptor, phentolamine, is useful in patients with pheochromocytoma crisis. Enalaprilat is the only ACE inhibitor available for parenteral use and may be particularly useful in treating hypertensive emergencies in patients with heart failure. However, ACE inhibitors may cause a precipitous fall in blood pressure in patients who are hypovolemic. Although useful as adjunctive therapy in hypertensive crises, diuretics should be used with caution in these patients because prior

  9. Managing marine disease emergencies in an era of rapid change

    PubMed Central

    Maynard, Jeffrey; Breyta, Rachel; Carnegie, Ryan B.; Dobson, Andy; Friedman, Carolyn S.; Froelich, Brett; Garren, Melissa; Gulland, Frances M. D.; Heron, Scott F.; Noble, Rachel T.; Revie, Crawford W.; Shields, Jeffrey D.; Vanderstichel, Raphaël; Weil, Ernesto; Wyllie-Echeverria, Sandy; Harvell, C. Drew

    2016-01-01

    Infectious marine diseases can decimate populations and are increasing among some taxa due to global change and our increasing reliance on marine environments. Marine diseases become emergencies when significant ecological, economic or social impacts occur. We can prepare for and manage these emergencies through improved surveillance, and the development and iterative refinement of approaches to mitigate disease and its impacts. Improving surveillance requires fast, accurate diagnoses, forecasting disease risk and real-time monitoring of disease-promoting environmental conditions. Diversifying impact mitigation involves increasing host resilience to disease, reducing pathogen abundance and managing environmental factors that facilitate disease. Disease surveillance and mitigation can be adaptive if informed by research advances and catalysed by communication among observers, researchers and decision-makers using information-sharing platforms. Recent increases in the awareness of the threats posed by marine diseases may lead to policy frameworks that facilitate the responses and management that marine disease emergencies require. PMID:26880835

  10. Managing marine disease emergencies in an era of rapid change.

    PubMed

    Groner, Maya L; Maynard, Jeffrey; Breyta, Rachel; Carnegie, Ryan B; Dobson, Andy; Friedman, Carolyn S; Froelich, Brett; Garren, Melissa; Gulland, Frances M D; Heron, Scott F; Noble, Rachel T; Revie, Crawford W; Shields, Jeffrey D; Vanderstichel, Raphaël; Weil, Ernesto; Wyllie-Echeverria, Sandy; Harvell, C Drew

    2016-03-05

    Infectious marine diseases can decimate populations and are increasing among some taxa due to global change and our increasing reliance on marine environments. Marine diseases become emergencies when significant ecological, economic or social impacts occur. We can prepare for and manage these emergencies through improved surveillance, and the development and iterative refinement of approaches to mitigate disease and its impacts. Improving surveillance requires fast, accurate diagnoses, forecasting disease risk and real-time monitoring of disease-promoting environmental conditions. Diversifying impact mitigation involves increasing host resilience to disease, reducing pathogen abundance and managing environmental factors that facilitate disease. Disease surveillance and mitigation can be adaptive if informed by research advances and catalysed by communication among observers, researchers and decision-makers using information-sharing platforms. Recent increases in the awareness of the threats posed by marine diseases may lead to policy frameworks that facilitate the responses and management that marine disease emergencies require. © 2016 The Author(s).

  11. Emerging Infectious Disease Surveillance in Southeast Asia: Cambodia, Indonesia, and the Naval Area Medical Research Unit 2

    DTIC Science & Technology

    2012-01-22

    change in the Asia-Pacific Emerging Infectious Disease Surveillance in Southeast Asia: Cambodia, Indonesia , and the Naval Area Medical...2012 to 00-00-2012 4. TITLE AND SUBTITLE Emerging Infectious Disease Surveillance in Southeast Asia: Cambodia, Indonesia , and the Naval Area Medical...denominator, this paper compares barriers to EID surveillance in Cambodia and Indonesia and presents key factors? uncovered through extensive interviews

  12. Decision support system for the response to infectious disease emergencies based on WebGIS and mobile services in China.

    PubMed

    Li, Ya-pin; Fang, Li-qun; Gao, Su-qing; Wang, Zhen; Gao, Hong-wei; Liu, Peng; Wang, Ze-Rui; Li, Yan-Li; Zhu, Xu-Guang; Li, Xin-Lou; Xu, Bo; Li, Yin-Jun; Yang, Hong; de Vlas, Sake J; Shi, Tao-Xing; Cao, Wu-Chun

    2013-01-01

    For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants. After a 2-year practice and application in infectious disease

  13. Information Supply Chain System for Managing Rare Infectious Diseases

    ERIC Educational Resources Information Center

    Gopalakrishna-Remani, Venugopal

    2012-01-01

    Timely identification and reporting of rare infectious diseases has important economic, social and health implications. In this study, we investigate how different stakeholders in the existing reporting system influence the timeliness in identification and reporting of rare infectious diseases. Building on the vision of the information supply…

  14. Information Supply Chain System for Managing Rare Infectious Diseases

    ERIC Educational Resources Information Center

    Gopalakrishna-Remani, Venugopal

    2012-01-01

    Timely identification and reporting of rare infectious diseases has important economic, social and health implications. In this study, we investigate how different stakeholders in the existing reporting system influence the timeliness in identification and reporting of rare infectious diseases. Building on the vision of the information supply…

  15. Emerging infectious diseases of plants: pathogen pollution, climate change and agrotechnology drivers.

    PubMed

    Anderson, Pamela K; Cunningham, Andrew A; Patel, Nikkita G; Morales, Francisco J; Epstein, Paul R; Daszak, Peter

    2004-10-01

    Emerging infectious diseases (EIDs) pose threats to conservation and public health. Here, we apply the definition of EIDs used in the medical and veterinary fields to botany and highlight a series of emerging plant diseases. We include EIDs of cultivated and wild plants, some of which are of significant conservation concern. The underlying cause of most plant EIDs is the anthropogenic introduction of parasites, although severe weather events are also important drivers of disease emergence. Much is known about crop plant EIDs, but there is little information about wild-plant EIDs, suggesting that their impact on conservation is underestimated. We conclude with recommendations for improving strategies for the surveillance and control of plant EIDs.

  16. Emerging Infectious Disease Leads to Rapid Population Declines of Common British Birds

    PubMed Central

    Toms, Mike P.; Peck, Kirsi M.; Kirkwood, James K.; Chantrey, Julian; Clatworthy, Innes R.; Evans, Andy D.; Hughes, Laura A.; Hutchinson, Oliver C.; John, Shinto K.; Pennycott, Tom W.; Perkins, Matthew W.; Rowley, Peter S.; Simpson, Vic R.; Tyler, Kevin M.; Cunningham, Andrew A.

    2010-01-01

    Emerging infectious diseases are increasingly cited as threats to wildlife, livestock and humans alike. They can threaten geographically isolated or critically endangered wildlife populations; however, relatively few studies have clearly demonstrated the extent to which emerging diseases can impact populations of common wildlife species. Here, we report the impact of an emerging protozoal disease on British populations of greenfinch Carduelis chloris and chaffinch Fringilla coelebs, two of the most common birds in Britain. Morphological and molecular analyses showed this to be due to Trichomonas gallinae. Trichomonosis emerged as a novel fatal disease of finches in Britain in 2005 and rapidly became epidemic within greenfinch, and to a lesser extent chaffinch, populations in 2006. By 2007, breeding populations of greenfinches and chaffinches in the geographic region of highest disease incidence had decreased by 35% and 21% respectively, representing mortality in excess of half a million birds. In contrast, declines were less pronounced or absent in these species in regions where the disease was found in intermediate or low incidence. Also, populations of dunnock Prunella modularis, which similarly feeds in gardens, but in which T. gallinae was rarely recorded, did not decline. This is the first trichomonosis epidemic reported in the scientific literature to negatively impact populations of free-ranging non-columbiform species, and such levels of mortality and decline due to an emerging infectious disease are unprecedented in British wild bird populations. This disease emergence event demonstrates the potential for a protozoan parasite to jump avian host taxonomic groups with dramatic effect over a short time period. PMID:20805869

  17. Infectious encephalitis: Management without etiological diagnosis 48hours after onset.

    PubMed

    Fillatre, P; Crabol, Y; Morand, P; Piroth, L; Honnorat, J; Stahl, J P; Lecuit, M

    2017-05-01

    The etiological diagnosis of infectious encephalitis is often not established 48hours after onset. We aimed to review existing literature data before providing management guidelines. We performed a literature search on PubMed using filters such as "since 01/01/2000", "human", "adults", "English or French", and "clinical trial/review/guidelines". We also used the Mesh search terms "encephalitis/therapy" and "encephalitis/diagnosis". With Mesh search terms "encephalitis/therapy" and "encephalitis/diagnosis", we retrieved 223 and 258 articles, respectively. With search terms "encephalitis and corticosteroid", we identified 38 articles, and with "encephalitis and doxycycline" without the above-mentioned filters we identified 85 articles. A total of 210 articles were included in the analysis. Etiological investigations must focus on recent travels, animal exposures, age, immunodeficiency, neurological damage characteristics, and potential extra-neurological signs. The interest of a diagnosis of encephalitis for which there is no specific treatment is also to discontinue any empirical treatments initially prescribed. Physicians must consider and search for autoimmune encephalitis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Hospital infectious disease emergency preparedness: a 2007 survey of infection control professionals.

    PubMed

    Rebmann, Terri; Wilson, Rita; LaPointe, Sue; Russell, Barbara; Moroz, Dianne

    2009-02-01

    Hospital preparedness for infectious disease emergencies is imperative. A 40-item hospital preparedness survey was administered to Association for Professionals in Infection Control and Epidemiology, Inc, members. Kruskal-Wallis tests were used to evaluate the relationship between hospital size and emergency preparedness in relation to various surge capacity measures. Significant findings were followed by Mann-Whitney U post hoc tests. Most hospitals have an infection control professional on their disaster committee, 24/7 infection control support, a health care worker prioritization plan for vaccine or antivirals, and nonhealth care facility surge beds but lack health care worker, laboratory, linen, and negative-pressure room surge capacity. Many hospitals participated in a disaster exercise recently and are stockpiling N95 respirators and medications. Few are stockpiling ventilators, surgical masks, or patient linens; those that are have infectious disease emergency planning.

  19. Information Systems Coordinate Emergency Management

    NASA Technical Reports Server (NTRS)

    2012-01-01

    The rescue crews have been searching for the woman for nearly a week. Hurricane Katrina devastated Hancock County, the southernmost point in Mississippi, and the woman had stayed through the storm in her beach house. There is little hope of finding her alive; the search teams know she is gone because the house is gone. Late at night in the art classroom of the school that is serving as the county s emergency operations center, Craig Harvey is discussing the search with the center s commander. Harvey is the Chief Operating Officer of a unique company called NVision Solutions Inc., based at NASA s Stennis Space Center in Bay St. Louis, only a couple of miles away. He and his entire staff have set up a volunteer operation in the art room, supporting the emergency management efforts using technology and capabilities the company developed through its NASA partnerships. As he talks to the commander, Harvey feels an idea taking shape that might lead them to the woman s location. Working with surface elevation data and hydrological principles, Harvey creates a map showing how the floodwaters from the storm would have flowed along the topography of the region around the woman s former home. Using the map, search crews find the woman s body in 15 minutes. Recovering individuals who have been lost is a sad reality of emergency management in the wake of a disaster like Hurricane Katrina in 2005. But the sooner answers can be provided, the sooner a community s overall recovery can take place. When damage is extensive, resources are scattered, and people are in dire need of food, shelter, and medical assistance, the speed and efficiency of emergency operations can be the key to limiting the impact of a disaster and speeding the process of recovery. And a key to quick and effective emergency planning and response is geographic information. With a host of Earth-observing satellites orbiting the globe at all times, NASA generates an unmatched wealth of data about our ever

  20. Exploiting dendrimer multivalency to combat emerging and re-emerging infectious diseases

    PubMed Central

    Mintzer, Meredith A.; Dane, Eric L.; O’Toole, George A.; Grinstaff, Mark W.

    2013-01-01

    The emergence and re-emergence of bacterial strains that are resistant to current antibiotics reveals the clinical need for new agents that possess broad-spectrum antibacterial activity. Furthermore, bacteriophobic coatings that repel bacteria are important for medical devices, as the lifetime, reliability, and performance of implant devices are hindered by bacterial adhesion and infection. Dendrimers, a specific class of monodisperse macromolecules, have recently shown potential to function as both antibacterial agents as well as antimicrobial surface coatings. This review discusses the limitations with currently used antibacterial agents and describes how various classes of dendrimers, including glycodendrimers, cationic dendrimers, anionic dendrimers, and peptide dendrimers, have the potential to improve upon or replace certain antibiotics. Furthermore, the unexplored areas in this field of research will be mentioned to present opportunities for additional studies regarding the use of dendrimers as antimicrobial agents. PMID:22126461

  1. Drivers of Emerging Infectious Disease Events as a Framework for Digital Detection

    PubMed Central

    Olson, Sarah H.; Benedum, Corey M.; Mekaru, Sumiko R.; Preston, Nicholas D.; Mazet, Jonna A.K.; Joly, Damien O.

    2015-01-01

    The growing field of digital disease detection, or epidemic intelligence, attempts to improve timely detection and awareness of infectious disease (ID) events. Early detection remains an important priority; thus, the next frontier for ID surveillance is to improve the recognition and monitoring of drivers (antecedent conditions) of ID emergence for signals that precede disease events. These data could help alert public health officials to indicators of elevated ID risk, thereby triggering targeted active surveillance and interventions. We believe that ID emergence risks can be anticipated through surveillance of their drivers, just as successful warning systems of climate-based, meteorologically sensitive diseases are supported by improved temperature and precipitation data. We present approaches to driver surveillance, gaps in the current literature, and a scientific framework for the creation of a digital warning system. Fulfilling the promise of driver surveillance will require concerted action to expand the collection of appropriate digital driver data. PMID:26196106

  2. Vaccines for Emerging Infectious Diseases: lessons from MERS coronavirus and Zika virus.

    PubMed

    Maslow, Joel N

    2017-08-28

    The past decade and a half has been characterized by numerous emerging infectious diseases. With each new threat, there has been a call for rapid vaccine development. Pathogens such as the Middle East Respiratory Syndrome coronavirus (MERS-CoV) and the Zika virus represent either new viral entities or viruses emergent in new geographic locales and characterized bywith novel complications. Both serve as paradigms for the global spread that can accompany new pathogens. In this paper, we review the epidemiology and pathogenesis of MERS-CoV and Zika virus with respect to vaccine development. The challenges in vaccine development and the approach to clinical trial design to test vaccine candidates for disease entities with a changing epidemiology are discussed.

  3. Designing an international policy and legal framework for the control of emerging infectious diseases: first steps.

    PubMed Central

    Plotkin, B. J.; Kimball, A. M.

    1997-01-01

    As the pace of emergence and reemergence of infectious diseases quickens, the International Health Regulations, which have served as the legal and policy framework of epidemic control for 45 years, are being revised by the World Health Organization (WHO). In this article, we review the recent history, legal construction, and application of these regulations and related international treaty-based sanitary measures, especially the General Agreement on Tariffs and Trade and the Agreement on the Application of Sanitary and Phytosanitary Measures, and the history of applying the regulations in the maritime and aviation industries. This review indicates that revision efforts should address 1) the limited scope of disease syndromes (and reporters of these syndromes) now in the regulations and 2) the mismatch between multisectoral factors causing disease emergence and the single agency (WHO) administering the regulations. The revised regulations should expand the scope of reporting and simultaneously broaden international agency coordination. PMID:9126439

  4. Drivers of Emerging Infectious Disease Events as a Framework for Digital Detection.

    PubMed

    Olson, Sarah H; Benedum, Corey M; Mekaru, Sumiko R; Preston, Nicholas D; Mazet, Jonna A K; Joly, Damien O; Brownstein, John S

    2015-08-01

    The growing field of digital disease detection, or epidemic intelligence, attempts to improve timely detection and awareness of infectious disease (ID) events. Early detection remains an important priority; thus, the next frontier for ID surveillance is to improve the recognition and monitoring of drivers (antecedent conditions) of ID emergence for signals that precede disease events. These data could help alert public health officials to indicators of elevated ID risk, thereby triggering targeted active surveillance and interventions. We believe that ID emergence risks can be anticipated through surveillance of their drivers, just as successful warning systems of climate-based, meteorologically sensitive diseases are supported by improved temperature and precipitation data. We present approaches to driver surveillance, gaps in the current literature, and a scientific framework for the creation of a digital warning system. Fulfilling the promise of driver surveillance will require concerted action to expand the collection of appropriate digital driver data.

  5. Bioterrorism and emerging infectious disease - antimicrobials, therapeutics and immune-modulators. SARS coronavirus.

    PubMed

    Shurtleff, Amy C

    2004-02-01

    The purpose of this meeting was to provide a forum for expert presentations and discussion about the threats of bioterrorism and emerging infectious diseases, and to address the issues relating to epidemics, prevention of infection and treatment of some of these emerging infectious diseases classified as potential agents of bioterror. Included in the talks were state-of-the-art presentations about infectious clone technology and recombinant viruses, pathogen and receptor interactions at the cellular and molecular level, genomic responses to infection, and new information on antiviral mechanisms of action. Severe acute respiratory syndrome (SARS) and progress toward understanding the epidemic was addressed, and other sessions were presented concerning immune therapy and immunopotentiation of disease, siRNA and gene silencing, host responses to pathogen infections, as well as the use of genetic engineering to circumvent and direct the immune response. Many discussions were held and data were presented about possible compounds and new drugs that may have antiviral properties, yet there were few discussions of any available new drugs. This report addresses reverse genetics of SARS virus, as well as its epidemiology, and a host of different recent approaches to developing antivirals effective against SARS, including some potential vaccine candidates. Also presented are hypotheses about the human immune response to SARS infection, as well as immune therapies against botulinum and anthrax toxins. This report also addresses antiviral approaches exploiting siRNAs, and different aspects of the host immune response to many of the different dangerous pathogens discussed at this meeting. Finally, approaches to circumventing and directing the immune response using genetic engineering will be reported.

  6. Interaction of the role of Concentrated Animal Feeding Operations (CAFOs) in Emerging Infectious Diseases (EIDS).

    PubMed

    Hollenbeck, James E

    2016-03-01

    Most significant change in the evolution of the influenza virus is the rapid growth of the Concentrated Animal Feeding Operations (CAFOs) on a global scale. These industrial agricultural operations have the potential of housing thousands of animals in a relatively small area. Emerging Infectious Diseases (EIDs) event can be considered as a shift in the pathogen-host-environment interplay characteristics described by Engering et al. (2013). These changes in the host-environment and the disease ecology are key to creating novel transmission patterns and selection of novel pathogens with a modification of genetic traits. With the development of CAFOs throughout the world, the need for training of animal caretakers to observe, identify, treat, vaccinate and cull if necessary is important to safeguard public health. The best defense against another pandemic of Emerging Infectious Diseases (EIDs) is the constant monitoring of the livestock and handlers of CAFOs and the live animal markets. These are the most likely epicenter of the next pandemic. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Risks of emerging infectious diseases: evolving threats in a changing area, the mediterranean basin.

    PubMed

    Vittecoq, M; Thomas, F; Jourdain, E; Moutou, F; Renaud, F; Gauthier-Clerc, M

    2014-02-01

    The Mediterranean basin is a biodiversity hotspot; it has historically had a large human presence that has shaped ecosystems for millennia. As the cradle of many civilizations, the area was one of the main theatres for transitions that punctuated both human and pathogen histories, which are intimately linked. Today we are living through another great historical transition summarized in the expression 'global changes'. In this context, we are witnessing a rise in the emergence of pathogens widely associated with aforementioned global changes. The Mediterranean basin might be especially vulnerable to this phenomenon due to the acute consequences global changes will have in this key intercontinental interface region. In addition, Arab revolutions and European economic crisis are creating both sanitary issues and presenting new opportunities to improve infectious disease control and prevention in the region. The aim of this review is to identify the impacts that ongoing changes might have on the risk of infectious disease emergence in the Mediterranean basin. We focussed on three key domains undergoing transformations: (i) resources, namely safe drinking water and animal products, (ii) socio-economic factors including health inequalities within countries and poor sanitary conditions linked to ongoing conflicts and (iii) movements of people and goods that are reshaped by current changes and are intimately linked to the risk of disease proliferation. Building on recent examples, we try to identify upcoming challenges and discuss ways to meet them in the light of existing international human and veterinary health guidelines and their possible improvements.

  8. Emerging infectious diseases in cetaceans worldwide and the possible role of environmental stressors.

    PubMed

    Van Bressem, Marie-Françoise; Raga, Juan Antonio; Di Guardo, Giovanni; Jepson, Paul D; Duignan, Padraig J; Siebert, Ursula; Barrett, Tom; Santos, Marcos César de Oliveira; Moreno, Ignacio B; Siciliano, Salvatore; Aguilar, Alex; Van Waerebeek, Koen

    2009-09-23

    We reviewed prominent emerging infectious diseases of cetaceans, examined their potential to impact populations, re-assessed zoonotic risk and evaluated the role of environmental stressors. Cetacean morbilliviruses and papillomaviruses as well as Brucella spp. and Toxoplasma gondii are thought to interfere with population abundance by inducing high mortalities, lowering reproductive success or by synergistically increasing the virulence of other diseases. Severe cases of lobomycosis and lobomycosis-like disease (LLD) may contribute to the death of some dolphins. The zoonotic hazard of marine mammal brucellosis and toxoplasmosis may have been underestimated, attributable to frequent misdiagnoses and underreporting, particularly in developing countries and remote areas where carcass handling without protective gear and human consumption of fresh cetacean products are commonplace. Environmental factors seem to play a role in the emergence and pathogenicity of morbillivirus epidemics, lobomycosis/LLD, toxoplasmosis, poxvirus-associated tattoo skin disease and, in harbour porpoises, infectious diseases of multifactorial aetiology. Inshore and estuarine cetaceans incur higher risks than pelagic cetaceans due to habitats often severely altered by anthropogenic factors such as chemical and biological contamination, direct and indirect fisheries interactions, traumatic injuries from vessel collisions and climate change.

  9. Use of telemedicine technologies in the management of infectious diseases: a review.

    PubMed

    Parmar, Parmvir; Mackie, David; Varghese, Sunil; Cooper, Curtis

    2015-04-01

    Telemedicine technologies are rapidly being integrated into infectious diseases programs with the aim of increasing access to infectious diseases specialty care for isolated populations and reducing costs. We summarize the utility and effectiveness of telemedicine in the evaluation and treatment of infectious diseases patients. The use of telemedicine in the management of acute infectious diseases, chronic hepatitis C, human immunodeficiency virus, and active pulmonary tuberculosis is considered. We recapitulate and evaluate the advantages of telemedicine described in other studies, present challenges to adopting telemedicine, and identify future opportunities for the use of telemedicine within the realm of clinical infectious diseases. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  10. Understanding gut-immune interactions in management of acute infectious diarrhoea.

    PubMed

    Calder, P; Hall, V

    2012-11-01

    This article discusses the role that immunity plays in the risk of diarrhoea and the potential role for probiotics in the management of acute infectious diarrhoea in older people, including antibiotic-associated diarrhoea and Clostridium difficile-associated diarrhoea.

  11. Social Media's New Role in Emergency Management

    SciTech Connect

    Ethan Huffman; Sara Prentice

    2008-03-01

    As technology continues to evolve, emergency management organizations must adapt to new ways of responding to the media and public. This paper examines a brief overview of social media's new role in emergency management. This includes definitions of social media, the benefits of utilizing social media, examples of social media being used and finally a discussion of how agencies, such as Department of Energy national laboratories, can begin including social media in their emergency management plans.

  12. Regulatory Information by Topic: Emergency Management

    EPA Pesticide Factsheets

    Regulatory information about emergencies, including chemical accident prevention, risk management plans (RMPs), chemical reporting, community right to know, and oil spills and hazardous substances releases.

  13. CDC's Emergency Management Program activities - worldwide, 2003-2012.

    PubMed

    2013-09-06

    In 2003, recognizing the increasing frequency and complexity of disease outbreaks and disasters and a greater risk for terrorism, CDC established the Emergency Operations Center (EOC), bringing together CDC staff members who respond to public health emergencies to enhance communication and coordination. To complement the physical EOC environment, CDC implemented the Incident Management System (IMS), a staffing structure and set of standard operational protocols and services to support and monitor CDC program-led responses to complex public health emergencies. The EOC and IMS are key components of CDC's Emergency Management Program (EMP), which applies emergency management principles to public health practice. To enumerate activities conducted by the EMP during 2003-2012, CDC analyzed data from daily reports and activity logs. The results of this analysis determined that, during 2003-2012, the EMP fully activated the EOC and IMS on 55 occasions to support responses to infectious disease outbreaks, natural disasters, national security events (e.g., conventions, presidential addresses, and international summits), mass gatherings (e.g., large sports and social events), and man-made disasters. On 109 other occasions, the EMP was used to support emergency responses that did not require full EOC activation, and the EMP also conducted 30 exercises and drills. This report provides an overview of those 194 EMP activities.

  14. Helpful Hints for School Emergency Management: Emergency "Go-Kits"

    ERIC Educational Resources Information Center

    Hill, Tara

    2006-01-01

    "Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. The Office of Safe and Drug-Free Schools (OSDFS) encourages schools to consider emergency management in the context of its four phases: mitigation and prevention, preparedness, response, and recovery. The preparedness phase…

  15. Management of Chronic Infectious Diseases in School Children. Revised Edition.

    ERIC Educational Resources Information Center

    Illinois State Board of Education, Springfield.

    This manual contains current guidelines for Illinois school personnel to follow when working with children who have infectious diseases. The first chapter focuses on school district development of policies and procedures and program implementation. The next chapter provides information on characteristics, mode of transmission, prevention, and…

  16. Development and Implementation of a Surveillance Network System for Emerging Infectious Diseases in the Caribbean (ARICABA)

    PubMed Central

    Kim, WonGyu Lewis; AnneDucharme, Chelsea; Bucher, Bernard Jean-Marie Philippe

    2011-01-01

    Dengue fever, including dengue hemorrhagic fever, has become a re-emerging public health threat in the Caribbean in the absence of a comprehensive regional surveillance system. In this deficiency, a project entitled ARICABA, strives to implement a pilot surveillance system across three islands: Martinique, St. Lucia, and Dominica. The aim of this project is to establish a network for epidemiological surveillance of infectious diseases, utilizing information and communication technology. This paper describes the system design and development strategies of a “network of networks” surveillance system for infectious diseases in the Caribbean. Also described are benefits, challenges, and limitations of this approach across the three island nations identified through direct observation, open-ended interviews, and email communications with an on-site IT consultant, key informants, and the project director. Identified core systems design of the ARICABA data warehouse include a disease monitoring system and a syndromic surveillance system. Three components comprise the development strategy: the data warehouse server, the geographical information system, and forecasting algorithms; these are recognized technical priorities of the surveillance system. A main benefit of the ARICABA surveillance system is improving responsiveness and representativeness of existing health systems through automated data collection, process, and transmission of information from various sources. Challenges include overcoming technology gaps between countries; real-time data collection points; multiple language support; and “component-oriented” development approaches. PMID:23569607

  17. Detection of infectious symptoms from VA emergency department and primary care clinical documentation.

    PubMed

    Matheny, Michael E; Fitzhenry, Fern; Speroff, Theodore; Green, Jennifer K; Griffith, Michelle L; Vasilevskis, Eduard E; Fielstein, Elliot M; Elkin, Peter L; Brown, Steven H

    2012-03-01

    The majority of clinical symptoms are stored as free text in the clinical record, and this information can inform clinical decision support and automated surveillance efforts if it can be accurately processed into computer interpretable data. We developed rule-based algorithms and evaluated a natural language processing (NLP) system for infectious symptom detection using clinical narratives. Training (60) and testing (444) documents were randomly selected from VA emergency department, urgent care, and primary care records. Each document was processed with NLP and independently manually reviewed by two clinicians with adjudication by referee. Infectious symptom detection rules were developed in the training set using keywords and SNOMED-CT concepts, and subsequently evaluated using the testing set. Overall symptom detection performance was measured with a precision of 0.91, a recall of 0.84, and an F measure of 0.87. Overall symptom detection with assertion performance was measured with a precision of 0.67, a recall of 0.62, and an F measure of 0.64. Among those instances in which the automated system matched the reference set determination for symptom, the system correctly detected 84.7% of positive assertions, 75.1% of negative assertions, and 0.7% of uncertain assertions. This work demonstrates how processed text could enable detection of non-specific symptom clusters for use in automated surveillance activities. Published by Elsevier Ireland Ltd.

  18. Development and Implementation of a Surveillance Network System for Emerging Infectious Diseases in the Caribbean (ARICABA).

    PubMed

    Kim, Wongyu Lewis; Anneducharme, Chelsea; Bucher, Bernard Jean-Marie Philippe

    2011-01-01

    Dengue fever, including dengue hemorrhagic fever, has become a re-emerging public health threat in the Caribbean in the absence of a comprehensive regional surveillance system. In this deficiency, a project entitled ARICABA, strives to implement a pilot surveillance system across three islands: Martinique, St. Lucia, and Dominica. The aim of this project is to establish a network for epidemiological surveillance of infectious diseases, utilizing information and communication technology. This paper describes the system design and development strategies of a "network of networks" surveillance system for infectious diseases in the Caribbean. Also described are benefits, challenges, and limitations of this approach across the three island nations identified through direct observation, open-ended interviews, and email communications with an on-site IT consultant, key informants, and the project director. Identified core systems design of the ARICABA data warehouse include a disease monitoring system and a syndromic surveillance system. Three components comprise the development strategy: the data warehouse server, the geographical information system, and forecasting algorithms; these are recognized technical priorities of the surveillance system. A main benefit of the ARICABA surveillance system is improving responsiveness and representativeness of existing health systems through automated data collection, process, and transmission of information from various sources. Challenges include overcoming technology gaps between countries; real-time data collection points; multiple language support; and "component-oriented" development approaches.

  19. Transmission dynamics of an emerging infectious disease in wildlife through host reproductive cycles

    PubMed Central

    Uchii, Kimiko; Telschow, Arndt; Minamoto, Toshifumi; Yamanaka, Hiroki; Honjo, Mie N; Matsui, Kazuaki; Kawabata, Zen'ichiro

    2011-01-01

    Emerging infectious diseases are major threats to wildlife populations. To enhance our understanding of the dynamics of these diseases, we investigated how host reproductive behavior and seasonal temperature variation drive transmission of infections among wild hosts, using the model system of cyprinid herpesvirus 3 (CyHV-3) disease in common carp. Our main findings were as follows: (1) a seroprevalence survey showed that CyHV-3 infection occurred mostly in adult hosts, (2) a quantitative assay for CyHV-3 in a host population demonstrated that CyHV-3 was most abundant in the spring when host reproduction occurred and water temperature increased simultaneously and (3) an analysis of the dynamics of CyHV-3 in water revealed that CyHV-3 concentration increased markedly in breeding habitats during host group mating. These results indicate that breeding habitats can become hot spots for transmission of infectious diseases if hosts aggregate for mating and the activation of pathogens occurs during the host breeding season. PMID:20740025

  20. Environmental and social influences on emerging infectious diseases: past, present and future.

    PubMed

    McMichael, A J

    2004-07-29

    During the processes of human population dispersal around the world over the past 50 000-100 000 years, along with associated cultural evolution and inter-population contact and conflict, there have been several major transitions in the relationships of Homo sapiens with the natural world, animate and inanimate. Each of these transitions has resulted in the emergence of new or unfamiliar infectious diseases. The three great historical transitions since the initial advent of agriculture and livestock herding, from ca. 10 000 years ago, occurred when: (i) early agrarian-based settlements enabled sylvatic enzootic microbes to make contact with Homo sapiens; (ii) early Eurasian civilizations (such as the Greek and Roman empires, China and south Asia) came into military and commercial contact, ca. 3000-2000 years ago, swapping their dominant infections; and (iii) European expansionism, over the past five centuries, caused the transoceanic spread of often lethal infectious diseases. This latter transition is best known in relation to the conquest of the Americas by Spanish conquistadores, when the inadvertent spread of measles, smallpox and influenza devastated the Amerindian populations.Today, we are living through the fourth of these great transitional periods. The contemporary spread and increased lability of various infectious diseases, new and old, reflect the combined and increasingly widespread impacts of demographic, environmental, behavioural, technological and other rapid changes in human ecology. Modern clinical medicine has, via blood transfusion, organ transplantation, and the use of hypodermic syringes, created new opportunities for microbes. These have contributed to the rising iatrogenic problems of hepatitis C, HIV/AIDS and several other viral infections. Meanwhile, the injudicious use of antibiotics has been a rare instance of human action actually increasing 'biodiversity'. Another aspect of this fourth transition is that modern hyper-hygienic living

  1. Environmental and social influences on emerging infectious diseases: past, present and future.

    PubMed Central

    McMichael, A J

    2004-01-01

    During the processes of human population dispersal around the world over the past 50 000-100 000 years, along with associated cultural evolution and inter-population contact and conflict, there have been several major transitions in the relationships of Homo sapiens with the natural world, animate and inanimate. Each of these transitions has resulted in the emergence of new or unfamiliar infectious diseases.The three great historical transitions since the initial advent of agriculture and livestock herding, from ca. 10 000 years ago, occurred when: (i) early agrarian-based settlements enabled sylvatic enzootic microbes to make contact with Homo sapiens; (ii) early Eurasian civilizations (such as the Greek and Roman empires, China and south Asia) came into military and commercial contact, ca. 3000-2000 years ago, swapping their dominant infections; and (iii) European expansionism, over the past five centuries, caused the transoceanic spread of often lethal infectious diseases. This latter transition is best known in relation to the conquest of the Americas by Spanish conquistadores, when the inadvertent spread of measles, smallpox and influenza devastated the Amerindian populations.Today, we are living through the fourth of these great transitional periods. The contemporary spread and increased lability of various infectious diseases, new and old, reflect the combined and increasingly widespread impacts of demographic, environmental, behavioural, technological and other rapid changes in human ecology. Modern clinical medicine has, via blood transfusion, organ transplantation, and the use of hypodermic syringes, created new opportunities for microbes. These have contributed to the rising iatrogenic problems of hepatitis C, HIV/AIDS and several other viral infections. Meanwhile, the injudicious use of antibiotics has been a rare instance of human action actually increasing 'biodiversity'.Another aspect of this fourth transition is that modern hyper-hygienic living

  2. Hazardous Materials Management System. A Guide for Local Emergency Managers.

    DTIC Science & Technology

    1981-07-01

    Office of Emergency Management 12240 N.E. Glisan, Portland, Oregon 97230 81 9 21 043 whom- son MCOEM 0779 July, 1981 Final Report HAZARDOUS MATERIALS...Emergency Management 12210 N. E. Glisan, Portland, Oregon 97230 FEMA REVIEW NOTICE "This report has been reviewed in the Federal Emergency Management Agency...Management Agency." SECURITY CLASSIFICATION OF ’.IS PAGE (When. Dot* f’Aor i . lb M INSTRUCTIONS REPORT DOCUENTATION PAGE BEOR COMPLETIORM I. REPORT NUMBER

  3. Defining European preparedness and research needs regarding emerging infectious animal diseases: results from a Delphi expert consultation.

    PubMed

    Wentholt, M T A; Cardoen, S; Imberechts, H; Van Huffel, X; Ooms, B W; Frewer, L J

    2012-02-01

    Emerging and major infectious animal diseases can have significant international impact on social, economic and environmental level, and are being driven by various factors. Prevention and control measures should be prepared at both national and international level to mitigate these disease risks. Research to support such policy development is mostly carried out at national level and dedicated transnational research programmes are still in its infancy. This research reports on part of a process to develop a common strategic research agenda on emerging and major infectious diseases of livestock in Europe, covering a 5-15-year time span. A two round online Delphi study was conducted to explore the views of experts on issues relating to research needs on emerging infectious diseases of livestock in Europe. Drivers that may influence the incidence of emerging infectious animal diseases in both the short (next 5 years) and medium term (10-15 years) were identified. Drivers related to regulatory measures and biological science developments were thought to decrease the incidence, and socio-economic factors to increase the incidence of emerging infectious animal diseases. From the first round a list of threats to animal health was compiled and participants combined these threats with relevant drivers in the second round. Next to identifying threats to animal health, also possible mitigatory actions to reduce the negative impact of these threats were identified. Participants emphasised that interdisciplinary research is needed to understand drivers of emerging infectious animal diseases, as well as to develop prevention and control measures which are both socio-economic and technical. From this it can be concluded that interdisciplinary research combining both natural and social research themes is required. Some of the European member states research budget needs to be allocated so that effective prevention and mitigation strategies can be developed.

  4. Zika Virus in Ontario: Evaluating a Rapid Risk Assessment Tool for Emerging Infectious Disease Threats.

    PubMed

    Van Meer, Ryan; Hohenadel, Karin; Fitzgerald-Husek, Alanna; Warshawsky, Bryna; Sider, Doug; Schwartz, Brian; Nelder, Mark P

    To determine the Ontario-specific risk of local and travel-related Zika virus transmission in the context of a public health emergency of international concern, Public Health Ontario (PHO) completed a rapid risk assessment (RRA) on January 29, 2016, using a newly developed RRA guidance tool. The RRA concluded that risk of local mosquito-borne transmission was low, with a high risk of imported cases through travel. The RRA was updated 3 times based on predetermined triggers. An independent evaluation assessed both the application of the RRA guidance tool (process evaluation) and the usefulness of the RRA (outcome evaluation). We conducted face-to-face, semi-structured interviews with 7 individuals who participated in the creation or review of the Zika virus RRA and 4 end-users at PHO and the Ministry of Health and Long-Term Care. An inductive thematic analysis of responses was undertaken, whereby themes were directly informed by the data. The process evaluation determined that most steps outlined in the RRA guidance tool were adhered to, including forming a cross-functional writing team, clarifying the scope and describing context, completing the RRA summary report, and updating the RRA based on predefined triggers. The outcome evaluation found that end-users judged the Zika virus RRA as evidence-informed, useful, consistent, and timely. The evaluation established that the locally tailored guidance tool, adapted from national and international approaches to RRAs, facilitated a systematic, evidence-informed, and timely formal RRA process at PHO for the Zika virus RRA, which met the needs of end-users. Based on the evaluation, PHO will modify future RRAs by incorporating some flexibility into the literature review process to support timeliness of the RRA, explicitly describing the limitations of studies used to inform the RRA, and refining risk algorithms to better suit emerging infectious disease threats. It is anticipated that these refinements will improve upon the

  5. Differential susceptibility in steelhead trout populations to an emergent MD strain of infectious hematopoietic necrosis virus.

    PubMed

    Breyta, Rachel; Jones, Amelia; Kurath, Gael

    2014-11-13

    A significant emergence of trout-adapted MD subgroup infectious hematopoietic necrosis virus (IHNV) began in the coastal region of Washington State, USA, in 2007. This emergence event lasted until 2011 and caused both asymptomatic adult fish infection and symptomatic epidemic disease and mortality in juvenile fish. Incidence of virus during this emergence demonstrated a heterogeneous distribution among rivers of the coastal region, leaving fish populations of some rivers apparently untouched while others suffered significant and recurrent infection and mortality (Breyta et. al. 2013; Dis Aquat Org 104:179-195). In this study, we examined the possible contribution of variations in susceptibility of fish populations, age-related resistance, and virus virulence to the observed landscape heterogeneity. We found that the most significant variable was host susceptibility: by controlled experimental challenge studies steelhead trout populations with no history of IHNV infection were 1 to 3 orders of magnitude more sensitive than a fish population with a long history of IHNV infection. In addition, 2 fish populations from the same river, which descended relatively recently from a common ancestral population, demonstrated 1 to 2 orders of magnitude difference in susceptibility. Fish age-related development of resistance was most evident in the more susceptible of 2 related fish populations. Finally, the strain of virus involved in the 2007 coastal Washington emergence had high virulence but was within the range of other known M group viruses tested. These results suggest that one major driver of landscape heterogeneity in the 2007 coastal Washington IHNV emergence was variation in fish population susceptibility and that this trait may have a heritable component.

  6. Differential susceptibility in steelhead trout populations to an emergent MD strain of infectious hematopoietic necrosis virus

    USGS Publications Warehouse

    Breyta, R.; Jones, Amelia; Kurath, Gael

    2014-01-01

    A significant emergence of trout-adapted MD subgroup infectious hematopoietic necrosis virus (IHNV) began in the coastal region of Washington State, USA, in 2007. This emergence event lasted until 2011 and caused both asymptomatic adult fish infection and symptomatic epidemic disease and mortality in juvenile fish. Incidence of virus during this emergence demonstrated a heterogeneous distribution among rivers of the coastal region, leaving fish populations of some rivers apparently untouched while others suffered significant and recurrent infection and mortality (Breyta et. al. 2013; Dis Aquat Org 104:179-195). In this study, we examined the possible contribution of variations in susceptibility of fish populations, age-related resistance, and virus virulence to the observed landscape heterogeneity. We found that the most significant variable was host susceptibility: by controlled experimental challenge studies steelhead trout populations with no history of IHNV infection were 1 to 3 orders of magnitude more sensitive than a fish population with a long history of IHNV infection. In addition, 2 fish populations from the same river, which descended relatively recently from a common ancestral population, demonstrated 1 to 2 orders of magnitude difference in susceptibility. Fish age-related development of resistance was most evident in the more susceptible of 2 related fish populations. Finally, the strain of virus involved in the 2007 coastal Washington emergence had high virulence but was within the range of other known M group viruses tested. These results suggest that one major driver of landscape heterogeneity in the 2007 coastal Washington IHNV emergence was variation in fish population susceptibility and that this trait may have a heritable component.

  7. Decision Support System for the Response to Infectious Disease Emergencies Based on WebGIS and Mobile Services in China

    PubMed Central

    Gao, Su-qing; Wang, Zhen; Gao, Hong-wei; Liu, Peng; Wang, Ze-rui; Li, Yan-li; Zhu, Xu-guang; Li, Xin-lou; Xu, Bo; Li, Yin-jun; Yang, Hong; de Vlas, Sake J.; Shi, Tao-xing; Cao, Wu-chun

    2013-01-01

    Background For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. Methodology/Principal Findings Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. Conclusions/Significance The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants

  8. Educating Emergency Managers About Weather -Related Hazards

    NASA Astrophysics Data System (ADS)

    Spangler, T. C.; Johnson, V.

    2006-12-01

    The most common crises that emergency managers face are those related to hazardous weather - snowstorms, floods, hurricanes, heat waves, tornadoes, etc. However, man-made disasters, such as accidental releases of hazardous substances or terrorist acts, also often have a weather component. For example, after the bombing of the Alfred P. Murrah Federal Building in Oklahoma City, emergency managers were concerned that thunderstorms in the area might cause the building to collapse, putting rescuers in further danger. Training emergency managers to recognize the importance of weather in disaster planning and response has been a small but important focus of the COMET Program's educational development effort. Topics addressed in COMET training modules that are pertinent to emergency management include fire weather, hurricanes, flood events, and air contaminant dispersion. Additionally, the module entitled Anticipating Hazardous Weather and Community Risk provides an overview of basic meteorological processes, describes a broad range of weather phenomenon, and then addresses what forecast products are available to emergency managers to assess a threat to their community. In many of the modules, learners are presented with scenarios that give them the opportunity to practice decision-making in hazardous weather situations. We will demonstrate some of those scenarios and discuss how training can be used to model good emergency management skills. We will discuss ways to communicate with the emergency management community and provide examples of how distance learning can be used to educate and train emergency managers.

  9. The Vietnam Initiative on Zoonotic Infections (VIZIONS): A Strategic Approach to Studying Emerging Zoonotic Infectious Diseases.

    PubMed

    Rabaa, Maia A; Tue, Ngo Tri; Phuc, Tran My; Carrique-Mas, Juan; Saylors, Karen; Cotten, Matthew; Bryant, Juliet E; Nghia, Ho Dang Trung; Cuong, Nguyen Van; Pham, Hong Anh; Berto, Alessandra; Phat, Voong Vinh; Dung, Tran Thi Ngoc; Bao, Long Hoang; Hoa, Ngo Thi; Wertheim, Heiman; Nadjm, Behzad; Monagin, Corina; van Doorn, H Rogier; Rahman, Motiur; Tra, My Phan Vu; Campbell, James I; Boni, Maciej F; Tam, Pham Thi Thanh; van der Hoek, Lia; Simmonds, Peter; Rambaut, Andrew; Toan, Tran Khanh; Van Vinh Chau, Nguyen; Hien, Tran Tinh; Wolfe, Nathan; Farrar, Jeremy J; Thwaites, Guy; Kellam, Paul; Woolhouse, Mark E J; Baker, Stephen

    2015-12-01

    The effect of newly emerging or re-emerging infectious diseases of zoonotic origin in human populations can be potentially catastrophic, and large-scale investigations of such diseases are highly challenging. The monitoring of emergence events is subject to ascertainment bias, whether at the level of species discovery, emerging disease events, or disease outbreaks in human populations. Disease surveillance is generally performed post hoc, driven by a response to recent events and by the availability of detection and identification technologies. Additionally, the inventory of pathogens that exist in mammalian and other reservoirs is incomplete, and identifying those with the potential to cause disease in humans is rarely possible in advance. A major step in understanding the burden and diversity of zoonotic infections, the local behavioral and demographic risks of infection, and the risk of emergence of these pathogens in human populations is to establish surveillance networks in populations that maintain regular contact with diverse animal populations, and to simultaneously characterize pathogen diversity in human and animal populations. Vietnam has been an epicenter of disease emergence over the last decade, and practices at the human/animal interface may facilitate the likelihood of spillover of zoonotic pathogens into humans. To tackle the scientific issues surrounding the origins and emergence of zoonotic infections in Vietnam, we have established The Vietnam Initiative on Zoonotic Infections (VIZIONS). This countrywide project, in which several international institutions collaborate with Vietnamese organizations, is combining clinical data, epidemiology, high-throughput sequencing, and social sciences to address relevant one-health questions. Here, we describe the primary aims of the project, the infrastructure established to address our scientific questions, and the current status of the project. Our principal objective is to develop an integrated approach to

  10. [Respiratory emergencies and airway management in children].

    PubMed

    Demirakca, S

    2015-06-01

    Respiratory emergencies in children are frequent and are caused by the specific airway anatomy and the susceptibility for infections.This article reviews the specific approach to pediatric airway management. According to the ABC guidelines of the European Resuscitation Council, the described algorithm should help to identify, classify, and treat such emergencies, giving those with less pediatric experience a tool for the management of respiratory illness in children. Focus is on the emergency care of the most common diseases in this age group.

  11. The Emerging Amphibian Fungal Disease, Chytridiomycosis: A Key Example of the Global Phenomenon of Wildlife Emerging Infectious Diseases.

    PubMed

    Kolby, Jonathan E; Daszak, Peter

    2016-06-01

    The spread of amphibian chytrid fungus, Batrachochytrium dendrobatidis, is associated with the emerging infectious wildlife disease chytridiomycosis. This fungus poses an overwhelming threat to global amphibian biodiversity and is contributing toward population declines and extinctions worldwide. Extremely low host-species specificity potentially threatens thousands of the 7,000+ amphibian species with infection, and hosts in additional classes of organisms have now also been identified, including crayfish and nematode worms.Soon after the discovery of B. dendrobatidis in 1999, it became apparent that this pathogen was already pandemic; dozens of countries and hundreds of amphibian species had already been exposed. The timeline of B. dendrobatidis's global emergence still remains a mystery, as does its point of origin. The reason why B. dendrobatidis seems to have only recently increased in virulence to catalyze this global disease event remains unknown, and despite 15 years of investigation, this wildlife pandemic continues primarily uncontrolled. Some disease treatments are effective on animals held in captivity, but there is currently no proven method to eradicate B. dendrobatidis from an affected habitat, nor have we been able to protect new regions from exposure despite knowledge of an approaching "wave" of B. dendrobatidis and ensuing disease.International spread of B. dendrobatidis is largely facilitated by the commercial trade in live amphibians. Chytridiomycosis was recently listed as a globally notifiable disease by the World Organization for Animal Health, but few countries, if any, have formally adopted recommended measures to control its spread. Wildlife diseases continue to emerge as a consequence of globalization, and greater effort is urgently needed to protect global health.

  12. Recommended modifications and applications of the Hospital Emergency Incident Command System for hospital emergency management.

    PubMed

    Arnold, Jeffrey L; Dembry, Louise-Marie; Tsai, Ming-Che; Dainiak, Nicholas; Rodoplu, Ulkümen; Schonfeld, David J; Paturas, James; Cannon, Christopher; Selig, Scott

    2005-01-01

    The Hospital Emergency Incident Command System (HEICS), now in its third edition, has emerged as a popular incident command system model for hospital emergency response in the United States and other countries. Since the inception of the HEICS in 1991, several events have transformed the requirements of hospital emergency management, including the 1995 Tokyo Subway sarin attack, the 2001 US anthrax letter attacks, and the 2003 Severe Acute Respiratory Syndrome (SARS) outbreaks in eastern Asia and Toronto, Canada. Several modifications of the HEICS are suggested to match the needs of hospital emergency management today, including: (1) an Incident Consultant in the Administrative Section of the HEICS to provide expert advice directly to the Incident Commander in chemical, biological, radiological, nuclear (CBRN) emergencies as needed, as well as consultation on mental health needs; (2) new unit leaders in the Operations Section to coordinate the management of contaminated or infectious patients in CBRN emergencies; (3) new unit leaders in the Operations Section to coordinate mental health support for patients, guests, healthcare workers, volunteers, and dependents in terrorism-related emergencies or events that produce significant mental health needs; (4) a new Decedent/Expectant Unit Leader in the Operations Section to coordinate the management of both types of patients together; and (5) a new Information Technology Unit Leader in the Logistics Section to coordinate the management of information technology and systems. New uses of the HEICS in hospital emergency management also are recommended, including: (1) the adoption of the HEICS as the conceptual framework for organizing all phases of hospital emergency management, including mitigation, preparedness, response, and recovery; and (2) the application of the HEICS not only to healthcare facilities, but also to healthcare systems. Finally, three levels of healthcare worker competencies in the HEICS are suggested

  13. Effectiveness of educational outreach in infectious diseases management: a cluster randomized trial in Uganda.

    PubMed

    Mbonye, Martin Kayitale; Burnett, Sarah M; Naikoba, Sarah; Ronald, Allan; Colebunders, Robert; Van Geertruyden, Jean-Pierre; Weaver, Marcia R

    2016-08-04

    Integrated Infectious Diseases Capacity Building Evaluation (IDCAP) teams designed and implemented two health worker in-service training approaches: 1) an off-site classroom-based integrated management of infectious diseases (IMID) course with distance learning aspects, and 2) on-site support (OSS), an educational outreach intervention. We tested the effects of OSS on workload and 12 facility performance indicators for emergency triage assessment and treatment, HIV testing, and malaria and pneumonia case management among outpatients by two subgroups: 1) mid-level practitioners (MLP) who attended IMID training (IMID-MLP) and 2) health workers who did not (No-IMID). Thirty-six health facilities participated in the IDCAP trial, with 18 randomly assigned to Arm A and 18 to Arm B. Two MLP in both arms received IMID. All providers at Arm A facilities received nine monthly OSS visits from April to December 2010 while Arm B did not. From November 2009 to December 2010, 777,667 outpatient visits occurred. We analyzed 669,580 (86.1 %) outpatient visits, where provider cadre was reported. Treatment was provided by 64 IMID-MLP and 1,515 No-IMID providers. The effect of OSS was measured by the difference in pre/post changes across arms after controlling for covariates (adjusted ratio of relative risks = a RRR). The effect of OSS on patients-per-provider-per-day (workload) among IMID-MLP (aRRR = 1.21; p = 0.48) and No-IMID (aRRR = 0.90; p = 0.44) was not statistically significant. Among IMID-MLP, OSS was effective for three indicators: malaria cases receiving an appropriate antimalarial (aRRR = 1.26, 99 % CI = 1.02-1.56), patients with negative malaria test result prescribed an antimalarial (aRRR = 0.49, 99 % CI = 0.26-0.92), and patients with acid-fast bacilli smear negative result receiving empiric treatment for acute respiratory infection (aRRR = 2.04, 99 % CI = 1.06-3.94). Among No-IMID, OSS was effective for two indicators

  14. Integrated management of childhood illness: an emphasis on the management of infectious diseases.

    PubMed

    Benguigui, Yehuda; Stein, Fernando

    2006-04-01

    The Integrated Management of Childhood Illness (IMCI) strategy has helped strengthen the application and expand coverage of key child survival interventions aimed at preventing deaths from infectious disease, respiratory illness, and malnutrition, whether at the health services, in the community, or at home. IMCI covers the prevention, treatment, and follow-up of the leading causes of mortality, which are responsible for at least two-thirds of deaths of children younger than 5 years in the countries of the Americas. The IMCI clinical guidelines take an evidence-based, syndrome approach to case managment that supports the rational, effective, and affordable use of drugs and diagnostic tools. When clinical resources are limited, the syndrome approach is a more realistic and cost-effective way to manage patients. Careful and systematic assessment of common symptoms and well-selected clinical signs provide sufficient information to guide effective actions.

  15. Molecular surveillance of traditional and emerging pathogens associated with canine infectious respiratory disease.

    PubMed

    Decaro, Nicola; Mari, Viviana; Larocca, Vittorio; Losurdo, Michele; Lanave, Gianvito; Lucente, Maria Stella; Corrente, Marialaura; Catella, Cristiana; Bo, Stefano; Elia, Gabriella; Torre, Giorgio; Grandolfo, Erika; Martella, Vito; Buonavoglia, Canio

    2016-08-30

    A molecular survey for traditional and emerging pathogens associated with canine infectious respiratory disease (CIRD) was conducted in Italy between 2011 and 2013 on a total of 138 dogs, including 78 early acute clinically ill CIRD animals, 22 non-clinical but exposed to clinically ill CIRD dogs and 38 CIRD convalescent dogs. The results showed that canine parainfluenza virus (CPIV) was the most commonly detected CIRD pathogen, followed by canine respiratory coronavirus (CRCoV), Bordetella bronchiseptica, Mycoplasma cynos, Mycoplasma canis and canine pneumovirus (CnPnV). Some classical CIRD agents, such as canine adenoviruses, canine distemper virus and canid herpesvirus 1, were not detected at all, as were not other emerging respiratory viruses (canine influenza virus, canine hepacivirus) and bacteria (Streptococcus equi subsp. zooepidemicus). Most severe forms of respiratory disease were observed in the presence of CPIV, CRCoV and M. cynos alone or in combination with other pathogens, whereas single CnPnV or M. canis infections were detected in dogs with no or very mild respiratory signs. Interestingly, only the association of M. cynos (alone or in combination with either CRCoV or M. canis) with severe clinical forms was statistically significant. The study, while confirming CPIV as the main responsible for CIRD occurrence, highlights the increasing role of recently discovered viruses, such as CRCoV and CnPnV, for which effective vaccines are not available in the market. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Deforestation-driven food-web collapse linked to emerging tropical infectious disease, Mycobacterium ulcerans

    PubMed Central

    Morris, Aaron L.; Guégan, Jean-François; Andreou, Demetra; Marsollier, Laurent; Carolan, Kevin; Le Croller, Marie; Sanhueza, Daniel; Gozlan, Rodolphe E.

    2016-01-01

    Generalist microorganisms are the agents of many emerging infectious diseases (EIDs), but their natural life cycles are difficult to predict due to the multiplicity of potential hosts and environmental reservoirs. Among 250 known human EIDs, many have been traced to tropical rain forests and specifically freshwater aquatic systems, which act as an interface between microbe-rich sediments or substrates and terrestrial habitats. Along with the rapid urbanization of developing countries, population encroachment, deforestation, and land-use modifications are expected to increase the risk of EID outbreaks. We show that the freshwater food-web collapse driven by land-use change has a nonlinear effect on the abundance of preferential hosts of a generalist bacterial pathogen, Mycobacterium ulcerans. This leads to an increase of the pathogen within systems at certain levels of environmental disturbance. The complex link between aquatic, terrestrial, and EID processes highlights the potential importance of species community composition and structure and species life history traits in disease risk estimation and mapping. Mechanisms such as the one shown here are also central in predicting how human-induced environmental change, for example, deforestation and changes in land use, may drive emergence. PMID:27957534

  17. ProMED-mail: 22 years of digital surveillance of emerging infectious diseases.

    PubMed

    Carrion, Malwina; Madoff, Lawrence C

    2017-05-01

    ProMED-mail (ProMED) was launched in 1994 as an email service to identify unusual health events related to emerging and re-emerging infectious diseases and toxins affecting humans, animals and plants. It is used daily by public health leaders, government officials at all levels, physicians, veterinarians and other healthcare workers, researchers, private companies, journalists and the general public. Reports are produced and commentary provided by a global team of subject matter experts in a variety of fields including virology, parasitology, epidemiology, entomology, veterinary and plant disease specialists. ProMED operates 24 hours a day, 7 days a week and has over 83 000 subscribers, representing every country in the world. Additionally, ProMED disseminates information via its website and through social media channels such as Twitter and Facebook as well as through RSS feeds. Over the last 22 years, it has been the first to report on numerous major and minor disease outbreaks including SARS, MERS, Ebola and the early spread of Zika. ProMED is transparent, apolitical, open to all and free of charge, making it an important and longstanding contributor to global health surveillance. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Optimal search patterns in honeybee orientation flights are robust against emerging infectious diseases

    PubMed Central

    Wolf, Stephan; Nicholls, Elizabeth; Reynolds, Andrew M.; Wells, Patricia; Lim, Ka S.; Paxton, Robert J.; Osborne, Juliet L.

    2016-01-01

    Lévy flights are scale-free (fractal) search patterns found in a wide range of animals. They can be an advantageous strategy promoting high encounter rates with rare cues that may indicate prey items, mating partners or navigational landmarks. The robustness of this behavioural strategy to ubiquitous threats to animal performance, such as pathogens, remains poorly understood. Using honeybees radar-tracked during their orientation flights in a novel landscape, we assess for the first time how two emerging infectious diseases (Nosema sp. and the Varroa-associated Deformed wing virus (DWV)) affect bees’ behavioural performance and search strategy. Nosema infection, unlike DWV, affected the spatial scale of orientation flights, causing significantly shorter and more compact flights. However, in stark contrast to disease-dependent temporal fractals, we find the same prevalence of optimal Lévy flight characteristics (μ ≈ 2) in both healthy and infected bees. We discuss the ecological and evolutionary implications of these surprising insights, arguing that Lévy search patterns are an emergent property of fundamental characteristics of neuronal and sensory components of the decision-making process, making them robust against diverse physiological effects of pathogen infection and possibly other stressors. PMID:27615605

  19. Deforestation-driven food-web collapse linked to emerging tropical infectious disease, Mycobacterium ulcerans.

    PubMed

    Morris, Aaron L; Guégan, Jean-François; Andreou, Demetra; Marsollier, Laurent; Carolan, Kevin; Le Croller, Marie; Sanhueza, Daniel; Gozlan, Rodolphe E

    2016-12-01

    Generalist microorganisms are the agents of many emerging infectious diseases (EIDs), but their natural life cycles are difficult to predict due to the multiplicity of potential hosts and environmental reservoirs. Among 250 known human EIDs, many have been traced to tropical rain forests and specifically freshwater aquatic systems, which act as an interface between microbe-rich sediments or substrates and terrestrial habitats. Along with the rapid urbanization of developing countries, population encroachment, deforestation, and land-use modifications are expected to increase the risk of EID outbreaks. We show that the freshwater food-web collapse driven by land-use change has a nonlinear effect on the abundance of preferential hosts of a generalist bacterial pathogen, Mycobacterium ulcerans. This leads to an increase of the pathogen within systems at certain levels of environmental disturbance. The complex link between aquatic, terrestrial, and EID processes highlights the potential importance of species community composition and structure and species life history traits in disease risk estimation and mapping. Mechanisms such as the one shown here are also central in predicting how human-induced environmental change, for example, deforestation and changes in land use, may drive emergence.

  20. Epidemiology and Management of Infectious Diseases in International Adoptees

    PubMed Central

    Murray, Thomas S.; Groth, M. Elizabeth; Weitzman, Carol; Cappello, Michael

    2005-01-01

    International adoptees represent a group of children with unique health care needs. Data from published studies, along with the recent experience of the Yale International Adoption Clinic, suggest that the risk of serious infections in adoptees is low, although infections associated with institutionalization still occur commonly. Interpretation of these data must be undertaken with caution, however, since many, if not most, international adoptees are not evaluated in specialty clinics. Thus, prospective studies designed to minimize selection and referral bias are needed in order to accurately define the risk of infectious and noninfectious diseases in all international adoptees. PMID:16020687

  1. [The management of infectious mediastinitis after the open heart surgery].

    PubMed

    Imada, T; Morishige, N; Nonaka, K; Yamanaka, J

    2000-03-01

    Between October of 1992 and September of 1998, we performed 604 open heart operations. Among them, 12 cases (1.9%) were complicated with postoperative infectious mediastinitis. Five patients (Group A) were treated by conservative therapy which consists of open drainage and intermittent closed irrigation with dilute povidone iodine solution. Seven patients (Group B) were treated surgically in addition to the above-mentioned conservative treatment. Among those patients, one patient developed fatal complication. We have realized that mental care of the patients was also very important when long term hospitalization was necessitated. The hyperbaric oxygen therapy seemed to be also effective for postoperative mediastinitis caused by MRSA.

  2. Epidemiology and management of infectious diseases in international adoptees.

    PubMed

    Murray, Thomas S; Groth, M Elizabeth; Weitzman, Carol; Cappello, Michael

    2005-07-01

    International adoptees represent a group of children with unique health care needs. Data from published studies, along with the recent experience of the Yale International Adoption Clinic, suggest that the risk of serious infections in adoptees is low, although infections associated with institutionalization still occur commonly. Interpretation of these data must be undertaken with caution, however, since many, if not most, international adoptees are not evaluated in specialty clinics. Thus, prospective studies designed to minimize selection and referral bias are needed in order to accurately define the risk of infectious and noninfectious diseases in all international adoptees.

  3. [Infectious disease emergencies. Responsibility of municipal, state and federal health protection authorities with reference to the international health regulations].

    PubMed

    Gottschalk, René; Dreesman, J; Leitmeyer, K; Krause, G

    2009-02-01

    Pandemic preparedness has become a catch phrase for politicians, government agencies and communities, both nationally and internationally. This is due to the increasing number of infectious diseases emergencies that are important challenges for health protection authorities, which was shown impressively when SARS emerged as the first pandemic in this millennium. In Germany, effective and efficient infection control is complex, with local health protection authorities having their own responsibilities. In the case of an emergency epidemic, regional health departments are responsible. Having authority over these are authorities on the federal state level as well as on the federal level. For the European Community, the European Centre for Disease Prevention and Control (ECDC) was established. The mission of this agency is to identify, assess and communicate current and emerging threats to human health posed by infectious diseases.

  4. Emergency Response and Management Activities

    EPA Pesticide Factsheets

    This quarterly report, highlighting accomplishments over the past several months, showcases EPA’s unique emergency response capabilities through the use of cutting-edge technologies and innovative cleanup strategies.

  5. Executive Summary: The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America

    PubMed Central

    Byington, Carrie L.; Shah, Samir S.; Alverson, Brian; Carter, Edward R.; Harrison, Christopher; Kaplan, Sheldon L.; Mace, Sharon E.; McCracken, George H.; Moore, Matthew R.; St Peter, Shawn D.; Stockwell, Jana A.; Swanson, Jack T.

    2011-01-01

    Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted. PMID:21890766

  6. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America.

    PubMed

    Bradley, John S; Byington, Carrie L; Shah, Samir S; Alverson, Brian; Carter, Edward R; Harrison, Christopher; Kaplan, Sheldon L; Mace, Sharon E; McCracken, George H; Moore, Matthew R; St Peter, Shawn D; Stockwell, Jana A; Swanson, Jack T

    2011-10-01

    Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.

  7. Executive summary: the management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America.

    PubMed

    Bradley, John S; Byington, Carrie L; Shah, Samir S; Alverson, Brian; Carter, Edward R; Harrison, Christopher; Kaplan, Sheldon L; Mace, Sharon E; McCracken, George H; Moore, Matthew R; St Peter, Shawn D; Stockwell, Jana A; Swanson, Jack T

    2011-10-01

    Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.

  8. Zika--an emerging infectious disease. The risk assessment from Polish perspective.

    PubMed

    Gańczak, Maria

    2016-01-01

    In the last years, attention has been paid to Zika virus (ZIKV) infection, the emerging vector-borne disease. It is responsible for major outbreaks in Africa, Asia and, more recently, in previously infection-naïve territories of the Pacific area, South America and Caribbean. The etiology, epidemiology, transmission, and clinical manifestations of ZIKV disease are discussed, along with the diagnostic possibilities in the aim to assessing the risk of its introduction to Poland. ZIKV is spread by Aedes mosquitoes which are not found throughout Poland. The prevention strategies adopted by national public health authorities should be based on a surveillance of imported cases and on increasing awareness among healthcare professionals and travelers. Due to a large number of asymptomatic ZIKV infections and limitations in the availability of diagnostic tests, monitoring based on laboratory results is likely to be unreliable in Poland. There are no requirements to report ZIKV infections to the European Centre for Disease Prevention and Control. Nevertheless, the global epidemic continues to spread, and despite travels of Poles to countries in which Aedes mosquitoes are active, Polish sportsmen will be travelling to Brazil in August 2016 to participate in the Olympic Games, the will also be true of the many fans who will follow them; therefore imported cases of ZIKV infection are possible. As the awareness of the infection risk will increase among medical staff and travelers, the number of suspected cases of travel-related ZIKV infections may rise in Poland. Medical staff should be informed where and how to report such cases. Thorough surveillance, adequate assessment of possible threats, action plans, rapid and effective intervention development, spread of up to date information of ZIKV, as well as other emerging or re-emerging infectious pathogens can play a key role in guaranteeing population health.

  9. Applying business intelligence innovations to emergency management.

    PubMed

    Schlegelmilch, Jeffrey; Albanese, Joseph

    2014-01-01

    The use of business intelligence (BI) is common among corporations in the private sector to improve business decision making and create insights for competitive advantage. Increasingly, emergency management agencies are using tools and processes similar to BI systems. With a more thorough understanding of the principles of BI and its supporting technologies, and a careful comparison to the business model of emergency management, this paper seeks to provide insights into how lessons from the private sector can contribute to the development of effective and efficient emergency management BI utilisation.

  10. Diagnosis and management of spinal cord emergencies.

    PubMed

    Flanagan, E P; Pittock, S J

    2017-01-01

    Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. In some situations prior comorbidity (e.g., advanced cancer) provides a clue, but in others (e.g., autoimmune myelopathies) it may come with little warning. Neurologic examination helps distinguish spinal cord emergencies from peripheral nervous system emergencies (e.g., Guillain-Barré), although some features overlap. Neurologic deficits are often severe and may quickly become irreversible, highlighting the importance of early diagnosis and treatment. Emergent magnetic resonance imaging (MRI) of the entire spine is the imaging modality of choice for nontraumatic spinal cord emergencies and helps differentiate extramedullary compressive causes (e.g., epidural abscess, metastatic compression, epidural hematoma) from intramedullary etiologies (e.g., transverse myelitis, infectious myelitis, or spinal cord infarct). The MRI characteristics may give a clue to the diagnosis (e.g., flow voids dorsal to the cord in dural arteriovenous fistula). However, additional investigations (e.g., aquaporin-4-IgG) are often necessary to diagnose intramedullary etiologies and guide treatment. Emergency decompressive surgery is necessary for many extramedullary compressive causes, either alone or in combination with other treatments (e.g., radiation) and preoperative neurologic deficit is the best predictor of outcome.

  11. Helpful Hints for School Emergency Management: Steps for Developing a School Emergency Management Plan

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. The U.S. Department of Education's Office of Safe and Drug-Free Schools strongly encourages schools and school districts to develop emergency management plans within the context of the four phases of emergency management:…

  12. Risk management of international trade: emergency preparedness.

    PubMed

    Torres, A; David, M J; Bowman, Q P

    2002-12-01

    Emergency preparedness and management are among the most important and critical issues facing animal health in the world today. The goals of a country for an animal health emergency management (AHEM) system should include the following: --being prepared to detect and manage an outbreak of a foreign animal disease --preventing the introduction of foreign and emerging animal pathogens --having an appropriate response system for control and eradication of the disease --having a system for recovery from animal health emergencies, including natural disasters. An AHEM system can no longer be limited to a single organisation within a country. In the event of a serious threat to the animal agriculture of a country, broader and more comprehensive participation is required. If not properly planned for, animal health emergencies can rapidly become national disasters. Therefore, it is essential that the central government of a country work towards these goals through partnerships with other Federal and State/Provincial/District organisations, academic institutions and national animal industries.

  13. Emergency management: expanding the disaster plan.

    PubMed

    Ross, Kevin L; Bing, Caryn M

    2007-06-01

    A comprehensive emergency management plan (CEMP) is key to minimizing the disruption of patient care and services during and after a natural or man-made disaster. The home health nurse can play a key role in enhancing, expanding, and evaluating the effectiveness of the organization's disaster plan. The components of a CEMP and lessons learned from actual implementation of disaster plans in home care are addressed. The disasters and emergencies of the past few years, such as threats of terrorism, hurricanes, floods, wildfires, tornadoes, and earthquakes, have validated the need to extend the emergency preparedness plan to a more comprehensive approach to emergency management. Communities, healthcare providers, and individuals/families all have been urged to take a more comprehensive look at their readiness for these types of events. Home healthcare organizations, including home health agencies, hospice providers, infusion providers, and medical equipment companies, can take a fresh and comprehensive look at their emergency management plan.

  14. Social media best practices in emergency management.

    PubMed

    Siskey, Ashley; Islam, Tanveer

    2016-01-01

    Social media platforms have become popular as means of communications in emergency management. Many people use social media sites such as Facebook and Twitter on a daily basis including during disaster events. Emergency management agencies (EMAs) need to recognize the value of not only having a presence on social media but also actively engaging stakeholders and the public on these sites. However, identifying best practices for the use of social media in emergency management is still in its infancy. The objective of this article is to begin to create or further define best practices for emergency managers to use social media sites particularly Facebook and Twitter in four key areas: 1) implementation, 2) education, 3) collaboration, and 4) communication. A list of recommendations of best practices is formulated for each key area and results from a nationwide survey on the use of social media by county EMAs are discussed in this article.

  15. Disaster management in Australia: the national emergency management system.

    PubMed

    Abrahams, J

    2001-06-01

    Australia has a well-established emergency management system to manage the threats to communities from natural and technological hazards. The key elements of the system are described with particular emphasis on the impact of disasters on Australia, fundamental concepts, and principles of planning. Emergency physicians have a key role in the development of emergency plans and in the overall health response to disasters. They can enhance their understanding of local, State and national arrangements by participating in exercises and appropriate disaster medicine and emergency management courses.

  16. A systematic review of community-based interventions for emerging zoonotic infectious diseases in Southeast Asia

    PubMed Central

    Halton, Kate; Sarna, Mohinder; Barnett, Adrian; Leonardo, Lydia; Graves, Nicholas

    2013-01-01

    Executive Summary Background Southeast Asia has been at the epicentre of recent epidemics of emerging and re-emerging zoonotic diseases. Community-based surveillance and control interventions have been heavily promoted but the most effective interventions have not been identified. Objectives This review evaluated evidence for the effectiveness of community-based surveillance interventions at monitoring and identifying emerging infectious disease; the effectiveness of community-based control interventions at reducing rates of emerging infectious disease; and contextual factors that influence intervention effectiveness. Inclusion criteria Participants Communities in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. Types of intervention(s) Non-pharmaceutical, non-vaccine, and community-based surveillance or prevention and control interventions targeting rabies, Nipah virus, dengue, SARS or avian influenza. Types of outcomes Primary outcomes: measures: of infection or disease; secondary outcomes: measures of intervention function. Types of studies Original quantitative studies published in English. Search strategy Databases searched (1980 to 2011): PubMed, CINAHL, ProQuest, EBSCOhost, Web of Science, Science Direct, Cochrane database of systematic reviews, WHOLIS, British Development Library, LILACS, World Bank (East Asia), Asian Development Bank. Methodological quality Two independent reviewers critically appraised studies using standard Joanna Briggs Institute instruments. Disagreements were resolved through discussion. Data extraction A customised tool was used to extract quantitative data on intervention(s), populations, study methods, and primary and secondary outcomes; and qualitative contextual information or narrative evidence about interventions. Data synthesis Data was synthesised in a narrative summary with the aid of tables. Meta-analysis was used to statistically pool quantitative results. Results

  17. Multi-taxa integrated landscape genetics for zoonotic infectious diseases: deciphering variables influencing disease emergence.

    PubMed

    Leo, Sarah S T; Gonzalez, Andrew; Millien, Virginie

    2016-05-01

    Zoonotic disease transmission systems involve sets of species interacting with each other and their environment. This complexity impedes development of disease monitoring and control programs that require reliable identification of spatial and biotic variables and mechanisms facilitating disease emergence. To overcome this difficulty, we propose a framework that simultaneously examines all species involved in disease emergence by integrating concepts and methods from population genetics, landscape ecology, and spatial statistics. Multi-taxa integrated landscape genetics (MTILG) can reveal how interspecific interactions and landscape variables influence disease emergence patterns. We test the potential of our MTILG-based framework by modelling the emergence of a disease system across multiple species dispersal, interspecific interaction, and landscape scenarios. Our simulations showed that both interspecific-dependent dispersal patterns and landscape characteristics significantly influenced disease spread. Using our framework, we were able to detect statistically similar inter-population genetic differences and highly correlated spatial genetic patterns that imply species-dependent dispersal. Additionally, species that were assigned coupled-dispersal patterns were affected to the same degree by similar landscape variables. This study underlines the importance of an integrated approach to investigating emergence of disease systems. MTILG is a robust approach for such studies and can identify potential avenues for targeted disease management strategies.

  18. Environmental fatty acids enable emergence of infectious Staphylococcus aureus resistant to FASII-targeted antimicrobials

    PubMed Central

    Morvan, Claire; Halpern, David; Kénanian, Gérald; Hays, Constantin; Anba-Mondoloni, Jamila; Brinster, Sophie; Kennedy, Sean; Trieu-Cuot, Patrick; Poyart, Claire; Lamberet, Gilles; Gloux, Karine; Gruss, Alexandra

    2016-01-01

    The bacterial pathway for fatty acid biosynthesis, FASII, is a target for development of new anti-staphylococcal drugs. This strategy is based on previous reports indicating that self-synthesized fatty acids appear to be indispensable for Staphylococcus aureus growth and virulence, although other bacteria can use exogenous fatty acids to compensate FASII inhibition. Here we report that staphylococci can become resistant to the FASII-targeted inhibitor triclosan via high frequency mutations in fabD, one of the FASII genes. The fabD mutants can be conditional for FASII and not require exogenous fatty acids for normal growth, and can use diverse fatty acid combinations (including host fatty acids) when FASII is blocked. These mutants show cross-resistance to inhibitors of other FASII enzymes and are infectious in mice. Clinical isolates bearing fabD polymorphisms also bypass FASII inhibition. We propose that fatty acid-rich environments within the host, in the presence of FASII inhibitors, might favour the emergence of staphylococcal strains displaying resistance to multiple FASII inhibitors. PMID:27703138

  19. The centenary of the discovery of trench fever, an emerging infectious disease of World War 1.

    PubMed

    Anstead, Gregory M

    2016-08-01

    In 1915, a British medical officer on the Western Front reported on a soldier with relapsing fever, headache, dizziness, lumbago, and shin pain. Within months, additional cases were described, mostly in frontline troops, and the new disease was called trench fever. More than 1 million troops were infected with trench fever during World War 1, with each affected soldier unfit for duty for more than 60 days. Diagnosis was challenging, because there were no pathognomonic signs and symptoms and the causative organism could not be cultured. For 3 years, the transmission and cause of trench fever were hotly debated. In 1918, two commissions identified that the disease was louse-borne. The bacterium Rickettsia quintana was consistently found in the gut and faeces of lice that had fed on patients with trench fever and its causative role was accepted in the 1920s. The organism was cultured in the 1960s and reclassified as Bartonella quintana; it was also found to cause endocarditis, peliosis hepatis, and bacillary angiomatosis. Subsequently, B quintana infection has been identified in new populations in the Andes, in homeless people in urban areas, and in individuals with HIV. The story of trench fever shows how war can lead to the recrudescence of an infectious disease and how medicine approached an emerging infection a century ago.

  20. Time for T? Immunoinformatics addresses vaccine design for neglected tropical and emerging infectious diseases

    PubMed Central

    Terry, Frances E; Moise, Leonard; Martin, Rebecca F; Torres, Melissa; Pilotte, Nils; Williams, Steven A; De Groot, Anne S

    2015-01-01

    Vaccines have been invaluable for global health, saving lives and reducing healthcare costs, while also raising the quality of human life. However, newly emerging infectious diseases (EID) and more well-established tropical disease pathogens present complex challenges to vaccine developers; in particular, neglected tropical diseases, which are most prevalent among the world’s poorest, include many pathogens with large sizes, multistage life cycles and a variety of nonhuman vectors. EID such as MERS-CoV and H7N9 are highly pathogenic for humans. For many of these pathogens, while their genomes are available, immune correlates of protection are currently unknown. These complexities make developing vaccines for EID and neglected tropical diseases all the more difficult. In this review, we describe the implementation of an immunoinformatics-driven approach to systematically search for key determinants of immunity in newly available genome sequence data and design vaccines. This approach holds promise for the development of 21st century vaccines, improving human health everywhere. PMID:25193104

  1. Management of blunt splenic injury in patients with concurrent infectious mononucleosis.

    PubMed

    Meguid, Ahmed A; Ivascu, Felicia A; Bair, Holly A; Kerr, Hugh; Bendick, Phillip J; McFall, Roberta K; Howells, Greg A

    2004-09-01

    Selective nonoperative management is appropriate for most blunt splenic injuries in adults and children, but the efficacy of this approach is unknown when injury occurs in patients with concurrent infectious mononucleosis. We have reviewed our experience during the past 23 years with the selective nonoperative management of blunt splenic injury in these patients. Medical record review identified nine patients with blunt splenic injury and infectious mononucleosis from 1978 to 2001, representing 3.3 per cent of our total trauma population with blunt splenic injury treated during that interval. Two patients underwent immediate splenectomy because of hemodynamic instability. Seven patients were admitted with the intent to treat nonoperatively. Five patients were successfully managed nonoperatively. Two patients failed nonoperative management and underwent splenectomy, one because of hemodynamic instability and one because of an infected splenic hematoma. Concurrent infectious mononucleosis does not preclude the successful nonoperative management of blunt splenic injury. This small subset of patients may be managed nonoperatively using the same criteria as for patients whose splenic injuries are not complicated by infectious mononucleosis.

  2. Emergence of MD type infectious hematopoietic necrosis virus in Washington State coastal steelhead trout

    USGS Publications Warehouse

    Breyta, Rachel; Jones, Amelia; Stewart, Bruce; Brunson, Ray; Thomas, Joan; Kerwin, John; Bertolini, Jim; Mumford, Sonia; Patterson, Chris; Kurath, Gael

    2013-01-01

    Infectious hematopoietic necrosis virus (IHNV) occurs in North America as 3 major phylogenetic groups designated U, M, and L. In coastal Washington State, IHNV has historically consisted of U genogroup viruses found predominantly in sockeye salmon Oncorhynchus nerka. M genogroup IHNV, which has host-specific virulence for rainbow and steelhead trout O. mykiss, was detected only once in coastal Washington prior to 2007, in an epidemic among juvenile steelhead trout in 1997. Beginning in 2007 and continuing through 2011, there were 8 IHNV epidemics in juvenile steelhead trout, involving 7 different fish culture facilities in 4 separate watersheds. During the same time period, IHNV was also detected in asymptomatic adult steelhead trout from 6 coastal watersheds. Genetic typing of 283 recent virus isolates from coastal Washington revealed that the great majority were in the M genogroup of IHNV and that there were 2 distinct waves of viral emergence between the years 2007 and 2011. IHNV type mG110M was dominant in coastal steelhead trout during 2007 to 2009, and type mG139M was dominant between 2010 and 2011. Phylogenetic analysis of viral isolates indicated that all coastal M genogroup viruses detected in 1997 and 2007 to 2011 were part of the MD subgroup and that several novel genetic variants related to the dominant types arose in the coastal sites. Comparison of spatial and temporal incidence of coastal MD viruses with that of the rest of the Pacific Northwest indicated that the likely source of the emergent viruses was Columbia River Basin steelhead trout. 

  3. Emergence of MD type infectious hematopoietic necrosis virus in Washington State coastal steelhead trout.

    PubMed

    Breyta, Rachel; Jones, Amelia; Stewart, Bruce; Brunson, Ray; Thomas, Joan; Kerwin, John; Bertolini, Jim; Mumford, Sonia; Patterson, Chris; Kurath, Gael

    2013-06-13

    Infectious hematopoietic necrosis virus (IHNV) occurs in North America as 3 major phylogenetic groups designated U, M, and L. In coastal Washington State, IHNV has historically consisted of U genogroup viruses found predominantly in sockeye salmon Oncorhynchus nerka. M genogroup IHNV, which has host-specific virulence for rainbow and steelhead trout O. mykiss, was detected only once in coastal Washington prior to 2007, in an epidemic among juvenile steelhead trout in 1997. Beginning in 2007 and continuing through 2011, there were 8 IHNV epidemics in juvenile steelhead trout, involving 7 different fish culture facilities in 4 separate watersheds. During the same time period, IHNV was also detected in asymptomatic adult steelhead trout from 6 coastal watersheds. Genetic typing of 283 recent virus isolates from coastal Washington revealed that the great majority were in the M genogroup of IHNV and that there were 2 distinct waves of viral emergence between the years 2007 and 2011. IHNV type mG110M was dominant in coastal steelhead trout during 2007 to 2009, and type mG139M was dominant between 2010 and 2011. Phylogenetic analysis of viral isolates indicated that all coastal M genogroup viruses detected in 1997 and 2007 to 2011 were part of the MD subgroup and that several novel genetic variants related to the dominant types arose in the coastal sites. Comparison of spatial and temporal incidence of coastal MD viruses with that of the rest of the Pacific Northwest indicated that the likely source of the emergent viruses was Columbia River Basin steelhead trout.

  4. Infectious Disease-related Emergency Department Visits Among Children in the US.

    PubMed

    Hasegawa, Kohei; Tsugawa, Yusuke; Cohen, Ari; Camargo, Carlos A

    2015-07-01

    Although most research on infectious diseases (IDs) has focused on hospitalizations, this provides an incomplete picture of healthcare utilization. We describe the burden and epidemiologic features of ID-related emergency department (ED) visits among U.S. children. We conducted a cross-sectional analysis of the Nationwide Emergency Department Sample, a nationally representative sample of ED patients. We identified children who presented to the ED with a primary diagnosis of ID. Outcome measures were ID-related ED visits, hospitalizations through the ED and ED charges. During 2011, we identified 1,914,509 ID-related ED visits among U.S. children, corresponding to a weighted estimate of 8,524,357 ED visits. This accounted for 28% of all ED visits by children. The frequency of ID-related ED visits was 10,290 visits per 100,000 children. The most common diagnoses were upper respiratory infection (41%), otitis media (18%) and lower respiratory infection (14%). Overall, 62% of ID-related ED visits were made by children with Medicaid; 35% were by those in the lowest income quartile. Among the ID-related ED visits, 424,725 (5%) resulted in hospitalization, with 513 hospitalizations per 100,000 children. The most common reason for hospitalization was lower respiratory infection, which accounted for 40% of all ID-related hospitalizations from the ED. Median charge per ED visit was $718, with total annual charges of $9.6 billion. The public health burden of IDs, as measured by ED visits, subsequent hospitalizations and associated charges, was substantial. We also found that children with markers of lower socioeconomic status comprised a disproportionately high proportion of ID-related ED visits.

  5. Emergent management of scorpion sting.

    PubMed

    Kluz-Zawadzka, Jolanta; Hartman-Ksycińska, Anna; Lewandowski, Bogumił

    2014-01-01

    Scorpionism (syndrome of scorpion stings) is an important public health problem in many regions of the world, not only in tropics and subtropics. As scorpions may be unintentionally transported to any place in the world and keeping scorpions as pets is becoming more popular, scorpion stings occur also in Poland. Therefore, health professionals should have the knowledge on the management of scorpion stings. This article discusses a case who was stung by scorpion and proposes an algorithm of management with such patients.

  6. Outcomes and infectious etiologies of febrile neutropenia in non-immunocompromised children who present in an emergency department.

    PubMed

    Pascual, C; Trenchs, V; Hernández-Bou, S; Català, A; Valls, A F; Luaces, C

    2016-10-01

    There are no unified protocols governing the management of healthy children with febrile neutropenia in the emergency department (ED). Conservative management is the norm, with admission and empirical broad-spectrum antibiotics prescribed, although viral infections are considered the most frequent etiology. The aim of this study was to describe the clinical outcomes and identified etiologies of unsuspected neutropenia in febrile immunocompetent children assessed in the ED. This was a retrospective study: well-appearing healthy children <18 years old with febrile moderate [absolute neutrophil count (ANC) 500-999 neutrophils ×10(9)/l] or severe (ANC <500 neutrophils ×10(9)/l) neutropenia diagnosed in ED between 2005 and 2013 were included. Patients newly diagnosed with hematologic or oncologic disease were excluded. We included 190 patients: 158 (83.2 %) with moderate and 32(16.8 %) with severe neutropenia. One hundred and one (53.2 %) were admitted; 48(47.5 %) with broad-spectrum antibiotics. The median length of stay was 3 days (IQR 3-5) and the median duration of neutropenia was 6 days (IQR 3-12). An infectious agent was identified in 23(12.1 %); 21 (91.3 %) were viruses. Four (2.1 %) children had a serious bacterial infection (SBI): urinary tract infection and lobar pneumonia (two cases each). All blood cultures performed (144; 75.8 %) were negative. Over the 1-year follow-up, one or several blood tests were performed on 167 patients (87.9 %); two (1.2 %) were diagnosed with autoimmune chronic neutropenia. Previously healthy children with moderate or severe febrile neutropenia have a low risk of SBI and a favorable clinical outcome. Less aggressive management could be carried out in most of them. Although chronic hematological diseases are infrequently diagnosed, serial ANC are necessary to detect them.

  7. Application of the analytic hierarchy process to a risk assessment of emerging infectious diseases in Shaoxing city in southern China.

    PubMed

    Tu, Chunyu; Fang, Yirong; Huang, Zhaohui; Tan, Rongmei

    2014-01-01

    This study aimed to assess the likelihood of an outbreak or epidemic of emerging infectious diseases (EIDs) in Shaoxing city, China, and its resulting impact to provide decision makers with quantitative, directive results. Factors related to the risk of EIDs were selected through meeting with experts and were arranged in a hierarchical structure. These evaluation factors were also weighted to allow the use of a point system for evaluation. As a result, 14 evaluation factors comprising a 3-layer hierarchy were generated. The riskiest top 10 EIDs were HIV/AIDS (consistency index [CI] = 3.206), cholera (CI = 3.103), SARS (CI = 2.804), acute schistosomiasis (CI = 2.784), malaria (CI = 2.777), legionellosis (CI = 2.743), avian influenza A/H5N1 (CI = 2.734), dengue fever (CI = 2.702), Escherichia coli O157:H7 enteritis (CI = 2.593), and plague (CI = 2.553). The risk assessment was specifically intended to support local and national government agencies in the management of high risk EIDs in their efforts to (i) make resource allocation decisions, (ii) make high-level planning decisions, and (iii) raise public awareness of the EID risk. The results showed that the EID risk in Shaoxing could be effectively assessed through an analytic hierarchy process.

  8. Emergency management of hyperemesis gravidarum.

    PubMed

    Summers, Anthony

    2012-07-01

    Most pregnant women experience morning sickness during the first 20 weeks of pregnancy. Often, the symptoms are mild, but recurring, nausea and vomiting; but the condition can also lead to dehydration, weight loss, electrolyte imbalance and blood volume depletion, and many women with more severe forms of the condition present to emergency departments. This article describes the presenting symptoms, causes of hyperemesis gravidarum, the associated clinical signs and complications, and the most common treatments offered.

  9. Management of infectious wildlife diseases: bridging conventional and bioeconomic approaches.

    PubMed

    Fenichel, Eli P; Horan, Richard D; Hickling, Graham J

    2010-06-01

    The primary goal of disease ecology is to understand disease systems and then use this information to inform management. The purpose of this paper is to show that conventional disease ecology models are limited in their ability to inform management of systems that are already infected, and to show how such models can be integrated with economic decision models to improve upon management recommendations. Management strategies based solely on disease ecology entail managing infected host populations or reservoir populations below a threshold value based on R0, the basic reproductive ratio of the pathogen, or a multiple-host version of this metric. These metrics measure a pathogen's ability to invade uninfected systems and do not account for postinfection dynamics. Once a pathogen has invaded a population, alternative management criteria are needed. Bioeconomic modeling offers a useful alternative approach to developing management criteria and facilitates the consideration of ecological-economic trade-offs so that diseases are managed in a cost-effective manner. The threshold concept takes on a more profound role under a bioeconomic paradigm: rather than unilaterally determining disease control choices, thresholds inform control choices and are influenced by them.

  10. Emerging Infectious Diseases in Free-Ranging Wildlife–Australian Zoo Based Wildlife Hospitals Contribute to National Surveillance

    PubMed Central

    Cox-Witton, Keren; Reiss, Andrea; Woods, Rupert; Grillo, Victoria; Baker, Rupert T.; Blyde, David J.; Boardman, Wayne; Cutter, Stephen; Lacasse, Claude; McCracken, Helen; Pyne, Michael; Smith, Ian; Vitali, Simone; Vogelnest, Larry; Wedd, Dion; Phillips, Martin; Bunn, Chris; Post, Lyndel

    2014-01-01

    Emerging infectious diseases are increasingly originating from wildlife. Many of these diseases have significant impacts on human health, domestic animal health, and biodiversity. Surveillance is the key to early detection of emerging diseases. A zoo based wildlife disease surveillance program developed in Australia incorporates disease information from free-ranging wildlife into the existing national wildlife health information system. This program uses a collaborative approach and provides a strong model for a disease surveillance program for free-ranging wildlife that enhances the national capacity for early detection of emerging diseases. PMID:24787430

  11. Emerging infectious diseases in free-ranging wildlife-Australian zoo based wildlife hospitals contribute to national surveillance.

    PubMed

    Cox-Witton, Keren; Reiss, Andrea; Woods, Rupert; Grillo, Victoria; Baker, Rupert T; Blyde, David J; Boardman, Wayne; Cutter, Stephen; Lacasse, Claude; McCracken, Helen; Pyne, Michael; Smith, Ian; Vitali, Simone; Vogelnest, Larry; Wedd, Dion; Phillips, Martin; Bunn, Chris; Post, Lyndel

    2014-01-01

    Emerging infectious diseases are increasingly originating from wildlife. Many of these diseases have significant impacts on human health, domestic animal health, and biodiversity. Surveillance is the key to early detection of emerging diseases. A zoo based wildlife disease surveillance program developed in Australia incorporates disease information from free-ranging wildlife into the existing national wildlife health information system. This program uses a collaborative approach and provides a strong model for a disease surveillance program for free-ranging wildlife that enhances the national capacity for early detection of emerging diseases.

  12. Emergency department management of shoulder dystocia.

    PubMed

    Del Portal, Daniel A; Horn, Amanda E; Vilke, Gary M; Chan, Theodore C; Ufberg, Jacob W

    2014-03-01

    Precipitous obstetric deliveries can occur outside of the labor and delivery suite, often in the emergency department (ED). Shoulder dystocia is an obstetric emergency with significant risk of adverse outcome. To review multiple techniques for managing a shoulder dystocia in the ED. We review various techniques and approaches for achieving delivery in the setting of shoulder dystocia. These include common maneuvers, controversial interventions, and interventions of last resort. Emergency physicians should be familiar with multiple techniques for managing a shoulder dystocia to reduce the chances of fetal and maternal morbidity and mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Federal emergency management planning. Student essay

    SciTech Connect

    McMullen, J.

    1987-03-23

    Prior to 1978, Federal Emergency Planning had been accomplished by several Federal Civil Agencies. To those who attempted to use the system, the process was described as dismal. There was no central point of departure for Federal emergency management information. Because the Federal Planning System was so bad, President Carter submitted to Congress Reorganization No. 3 of 1978 which consolidated the oversight responsibility for Federal emergency planning into a single agency known as the Federal Emergency Management Agency (FEMA). Consolidated under FEMA were all authorities and functions delegated by law to the President and the Executive for Federal emergency planning. The spectrum of Federal preparedness planning performed by FEMA ranges from a natural disaster to a nuclear attack on the United States. Although constrained by increasing Federal budget deficits and the demand for fiscal soundness, many in FEMA believe that the Agency is prepared to cope with a future that is characterized as complex, and full of uncertainties.

  14. Need of surveillance response systems to combat Ebola outbreaks and other emerging infectious diseases in African countries.

    PubMed

    Tambo, Ernest; Ugwu, Emmanuel Chidiebere; Ngogang, Jeane Yonkeu

    2014-01-01

    There is growing concern in Sub-Saharan Africa about the spread of the Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, and the public health burden that it ensues. Since 1976, there have been 885,343 suspected and laboratory confirmed cases of EVD and the disease has claimed 2,512 cases and 932 fatality in West Africa. There are certain requirements that must be met when responding to EVD outbreaks and this process could incur certain challenges. For the purposes of this paper, five have been identified: (i) the deficiency in the development and implementation of surveillance response systems against Ebola and others infectious disease outbreaks in Africa; (ii) the lack of education and knowledge resulting in an EVD outbreak triggering panic, anxiety, psychosocial trauma, isolation and dignity impounding, stigmatisation, community ostracism and resistance to associated socio-ecological and public health consequences; (iii) limited financial resources, human technical capacity and weak community and national health system operational plans for prevention and control responses, practices and management; (iv) inadequate leadership and coordination; and (v) the lack of development of new strategies, tools and approaches, such as improved diagnostics and novel therapies including vaccines which can assist in preventing, controlling and containing Ebola outbreaks as well as the spread of the disease. Hence, there is an urgent need to develop and implement an active early warning alert and surveillance response system for outbreak response and control of emerging infectious diseases. Understanding the unending risks of transmission dynamics and resurgence is essential in implementing rapid effective response interventions tailored to specific local settings and contexts. (i) national and regional inter-sectorial and trans-disciplinary surveillance response systems that include early warnings, as well as critical human resources development, must be

  15. Need of surveillance response systems to combat Ebola outbreaks and other emerging infectious diseases in African countries

    PubMed Central

    2014-01-01

    There is growing concern in Sub-Saharan Africa about the spread of the Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, and the public health burden that it ensues. Since 1976, there have been 885,343 suspected and laboratory confirmed cases of EVD and the disease has claimed 2,512 cases and 932 fatality in West Africa. There are certain requirements that must be met when responding to EVD outbreaks and this process could incur certain challenges. For the purposes of this paper, five have been identified: (i) the deficiency in the development and implementation of surveillance response systems against Ebola and others infectious disease outbreaks in Africa; (ii) the lack of education and knowledge resulting in an EVD outbreak triggering panic, anxiety, psychosocial trauma, isolation and dignity impounding, stigmatisation, community ostracism and resistance to associated socio-ecological and public health consequences; (iii) limited financial resources, human technical capacity and weak community and national health system operational plans for prevention and control responses, practices and management; (iv) inadequate leadership and coordination; and (v) the lack of development of new strategies, tools and approaches, such as improved diagnostics and novel therapies including vaccines which can assist in preventing, controlling and containing Ebola outbreaks as well as the spread of the disease. Hence, there is an urgent need to develop and implement an active early warning alert and surveillance response system for outbreak response and control of emerging infectious diseases. Understanding the unending risks of transmission dynamics and resurgence is essential in implementing rapid effective response interventions tailored to specific local settings and contexts. Therefore, the following actions are recommended: (i) national and regional inter-sectorial and trans-disciplinary surveillance response systems that include early warnings, as well

  16. The Intestinal Microbiome in Infectious Diseases: The Clinical Relevance of a Rapidly Emerging Field.

    PubMed

    Harris, Vanessa C; Haak, Bastiaan W; Boele van Hensbroek, Michaël; Wiersinga, Willem J

    2017-01-01

    The field of infectious disease is undergoing a paradigm shift as the intestinal microbiome is becoming understood. The aim of this review is to inform infectious disease physicians of the potential relevance of the intestinal microbiome to their practice. We searched Medline using both index and text words relating to infectious diseases, microbiome, and probiotics. Relevant articles published up through 2017 were reviewed within Rayyan. The review illustrates pathophysiologic concepts linking the microbiome and infectious diseases; specifically, the intestinal microbiome's relevance to early immune development, the microbiome and enteric infections, the microbiome's relevance in compromised hosts, and antimicrobial resistance. Within each subject, there are specific examples of diseases and at-risk patient populations where a role for the microbiome has been strongly established. This provides an overview of the significance of the intestinal microbiome to microbiology, pediatric and adult infectious diseases with an underpinning of concepts useful for the practicing clinician.

  17. The Intestinal Microbiome in Infectious Diseases: The Clinical Relevance of a Rapidly Emerging Field

    PubMed Central

    Haak, Bastiaan W; Boele van Hensbroek, Michaël; Wiersinga, Willem J

    2017-01-01

    Abstract The field of infectious disease is undergoing a paradigm shift as the intestinal microbiome is becoming understood. The aim of this review is to inform infectious disease physicians of the potential relevance of the intestinal microbiome to their practice. We searched Medline using both index and text words relating to infectious diseases, microbiome, and probiotics. Relevant articles published up through 2017 were reviewed within Rayyan. The review illustrates pathophysiologic concepts linking the microbiome and infectious diseases; specifically, the intestinal microbiome’s relevance to early immune development, the microbiome and enteric infections, the microbiome’s relevance in compromised hosts, and antimicrobial resistance. Within each subject, there are specific examples of diseases and at-risk patient populations where a role for the microbiome has been strongly established. This provides an overview of the significance of the intestinal microbiome to microbiology, pediatric and adult infectious diseases with an underpinning of concepts useful for the practicing clinician. PMID:28852682

  18. Synanthropy of wild mammals as a determinant of emerging infectious diseases in the Asian-Australasian region.

    PubMed

    McFarlane, Ro; Sleigh, Adrian; McMichael, Tony

    2012-03-01

    Humans create ecologically simplified landscapes that favour some wildlife species, but not others. Here, we explore the possibility that those species that tolerate or do well in human-modified environments, or 'synanthropic' species, are predominantly the hosts of zoonotic emerging and re-emerging infectious diseases (EIDs). We do this using global wildlife conservation data and wildlife host information extracted from systematically reviewed emerging infectious disease literature. The evidence for this relationship is examined with special emphasis on the Australasian, South East Asian and East Asian regions. We find that synanthropic wildlife hosts are approximately 15 times more likely than other wildlife in this region to be the source of emerging infectious diseases, and this association is essentially independent of the taxonomy of the species. A significant positive association with EIDs is also evident for those wildlife species of low conservation risk. Since the increase and spread of native and introduced species able to adapt to human-induced landscape change is at the expense of those species most vulnerable to habitat loss, our findings suggest a mechanism linking land conversion, global decline in biodiversity and a rise in EIDs of wildlife origin.

  19. Applications of Remote Sensing to Emergency Management.

    DTIC Science & Technology

    1980-02-15

    damage, loss of life, etc. to permit uniform guidelines for management. Many small emergencies such as a tornado in a rural area can be managed by local...States. Unfortunately, it is difficult to specify the amount of damage, loss of life, etc. to permit uniform guidelines for management. Many small emer...caused disaster, an act of terrorism or an act of agression between nations somewhere in the world. Based on 1955 costs, the annual loss from natural

  20. Concurrent diphtheria and infectious mononucleosis: difficulties for management, investigation and control of diphtheria in developing countries.

    PubMed

    Mattos-Guaraldi, A L; Damasco, P V; Gomes, D L R; Melendez, M G; Santos, L S; Marinelli, R S; Napoleão, F; Sabbadini, P S; Santos, C S; Moreira, L O; Hirata, R

    2011-11-01

    We report a case of concurrent diphtheria and infectious mononucleosis in an 11-year-old Brazilian child. Two days after specific treatment for diphtheria was started the patient was discharged following clinical recovery. This case highlights the difficulties in the clinical diagnosis of diphtheria in partially immunized individuals, and for the management and control of diphtheria in developing countries.

  1. Tularemia, a re-emerging infectious disease in Iran and neighboring countrie

    PubMed Central

    Zargar, Afsaneh; Maurin, Max; Mostafavi, Ehsan

    2015-01-01

    OBJECTIVES: Tularemia is a zoonotic disease transmitted by direct contact with infected animals and through arthropod bites, inhalation of contaminated aerosols, ingestion of contaminated meat or water, and skin contact with any infected material. It is widespread throughout the northern hemisphere, including Iran and its neighbors to the north, northeast, and northwest. METHODS: In this paper, the epidemiology of tularemia as a re-emerging infectious disease in the world with a focus on Iran and the neighboring countries is reviewed. RESULTS: In Iran, positive serological tests were first reported in 1973, in wildlife and domestic livestock in the northwestern and southeastern parts of the country. The first human case was reported in 1980 in the southwest of Iran, and recent studies conducted among at-risk populations in the western, southeastern, and southwestern parts of Iran revealed seroprevalences of 14.4, 6.52, and 6%, respectively. CONCLUSIONS: Several factors may explain the absence of reported tularemia cases in Iran since 1980. Tularemia may be underdiagnosed in Iran because Francisella tularensis subspecies holarctica is likely to be the major etiological agent and usually causes mild to moderately severe disease. Furthermore, tularemia is not a disease extensively studied in the medical educational system in Iran, and empirical therapy may be effective in many cases. Finally, it should be noted that laboratories capable of diagnosing tularemia have only been established in the last few years. Since both recent and older studies have consistently found tularemia antibodies in humans and animals, the surveillance of this disease should receive more attention. In particular, it would be worthwhile for clinical researchers to confirm tularemia cases more often by isolating F. tularensis from infected humans and animals. PMID:25773439

  2. Medical emergency management among Iranian dentists.

    PubMed

    Khami, Mohammad Reza; Yazdani, Reza; Afzalimoghaddam, Mohammad; Razeghi, Samaneh; Moscowchi, Anahita

    2014-11-01

    More than 18,000 patients need medical emergencies management in dental offices in Iran annually. The present study investigates medical emergencies management among Iranian dentists. From the list of the cell phone numbers of the dentists practicing in the city of Tehran, 210 dentists were selected randomly. A self-administered questionnaire was used as the data collection instrument. The questionnaire requested information on personal and professional characteristics of the dentists, as well as their knowledge and self-reported practice in the field of medical emergency management, and availability of required drugs and equipments to manage medical emergencies in their offices. Totally, 177 dentists (84%) completed the questionnaire. Less than 60% of the participants were knowledgeable about characteristics of hypoglycemic patient, chest pain with cardiac origin, and true cardiopulmonary resuscitation (CPR) practice. Regarding practice, less than one quarter of the respondents acquired acceptable scores. In regression models, higher practice scores were significantly associated with higher knowledge scores (p < 0.001). The results call for a need to further education on the subject for dentists. Continuing education and changing dental curriculum in the various forms seems to be useful in enhancement of the self-reported knowledge and practice of dentists. To successful control of medical emergencies in the dental office, dentists must be prepared to recognize and manage a variety of such conditions. In addition to dentist's knowledge and skill, availability of necessary equipments and trained staff is also of critical importance.

  3. Emergent exploration via novelty management.

    PubMed

    Gordon, Goren; Fonio, Ehud; Ahissar, Ehud

    2014-09-17

    When encountering novel environments, animals perform complex yet structured exploratory behaviors. Despite their typical structuring, the principles underlying exploratory patterns are still not sufficiently understood. Here we analyzed exploratory behavioral data from two modalities: whisking and locomotion in rats and mice. We found that these rodents maximized novelty signal-to-noise ratio during each exploration episode, where novelty is defined as the accumulated information gain. We further found that these rodents maximized novelty during outbound exploration, used novelty-triggered withdrawal-like retreat behavior, and explored the environment in a novelty-descending sequence. We applied a hierarchical curiosity model, which incorporates these principles, to both modalities. We show that the model captures the major components of exploratory behavior in multiple timescales: single excursions, exploratory episodes, and developmental timeline. The model predicted that novelty is managed across exploratory modalities. Using a novel experimental setup in which mice encountered a novel object for the first time in their life, we tested and validated this prediction. Further predictions, related to the development of brain circuitry, are described. This study demonstrates that rodents select exploratory actions according to a novelty management framework and suggests a plausible mechanism by which mammalian exploration primitives can be learned during development and integrated in adult exploration of complex environments. Copyright © 2014 the authors 0270-6474/14/3412646-16$15.00/0.

  4. [Radiation management for infectious waste from nuclear medicine studies].

    PubMed

    Kondo, Yuji; Takeuchi, Yasuyuki; Masumoto, Kazuya

    2003-09-01

    An industrial waste management service has refused to collect medical waste from our hospital owing to radioactive contamination found in the waste in July 2000. An investigation revealed that the "three-way stopcock" and handling diapers used for radioisotope examination were the radioactive contaminants. We therefore reconsidered the system of medical waste maintenance especially for radioactive materials. Since February 2001, we have resumed radiation maintenance by following the manual for the handling diapers of patients administered radiopharmaceuticals issued by five organizations associated with JRS, JSRT, JSNM, JSNMT, and JARPM. A major change was to check the radioactive waste at the individual departments and at a centralized check system. This eliminated the problem of dumping radioactive material into medical waste as well as resolving the concerns of the industrial waste management service.

  5. Use of mobile phones in an emergency reporting system for infectious disease surveillance after the Sichuan earthquake in China

    PubMed Central

    Yang, Changhong; Luo, Xiangshu; Gong, Peng

    2009-01-01

    Abstract Problem Quick detection and response were essential for preventing outbreaks of infectious diseases after the Sichuan earthquake. However, the existing public health communication system in Sichuan province, China, was severely damaged by the earthquake. Approach The Chinese Center for Disease Control and Prevention set up a mobile phone emergency reporting system. In total, 495 light-powered mobile phones were delivered to local health-care agencies in earthquake affected areas. All phones were loaded with software designed for inputting and transmitting cases of infectious disease directly to a national database for further analysis. Local setting The emergency reporting system was set up in 14 counties hit hardest by the earthquake in Sichuan province, China. Relevant changes One week after delivering mobile phones to earthquake-affected areas, the number of health-care agencies at the township level that had filed reports returned to the normal level. The number of cases reported by using mobile phones accounted for as much as 52.9% of the total cases reported weekly from 19 May to 13 July in those areas Lessons learned The mobile phone is a useful communication tool for infectious disease surveillance in areas hit by natural disasters. Nevertheless, plans must be made ahead of time and be included in emergency preparedness programmes. PMID:19705013

  6. Use of mobile phones in an emergency reporting system for infectious disease surveillance after the Sichuan earthquake in China.

    PubMed

    Yang, Changhong; Yang, Jun; Luo, Xiangshu; Gong, Peng

    2009-08-01

    Quick detection and response were essential for preventing outbreaks of infectious diseases after the Sichuan earthquake. However, the existing public health communication system in Sichuan province, China, was severely damaged by the earthquake. The Chinese Center for Disease Control and Prevention set up a mobile phone emergency reporting system. In total, 495 light-powered mobile phones were delivered to local health-care agencies in earthquake affected areas. All phones were loaded with software designed for inputting and transmitting cases of infectious disease directly to a national database for further analysis. The emergency reporting system was set up in 14 counties hit hardest by the earthquake in Sichuan province, China. One week after delivering mobile phones to earthquake-affected areas, the number of health-care agencies at the township level that had filed reports returned to the normal level. The number of cases reported by using mobile phones accounted for as much as 52.9% of the total cases reported weekly from 19 May to 13 July in those areas The mobile phone is a useful communication tool for infectious disease surveillance in areas hit by natural disasters. Nevertheless, plans must be made ahead of time and be included in emergency preparedness programmes.

  7. Preventing Emerging Infectious Diseases: A Strategy for the 21st Century. Overview of the Updated CDC plan.

    PubMed

    1998-09-11

    Societal, technological, and environmental factors continue to have a dramatic effect on infectious diseases worldwide, facilitating the emergence of new diseases and the reemergence of old ones, sometimes in drug-resistant forms. Modern demographic and ecologic conditions that favor the spread of infectious diseases include rapid population growth; increasing poverty and urban migration; more frequent movement across international boundaries by tourists, workers, immigrants, and refugees; alterations in the habitats of animals and arthropods that transmit disease; increasing numbers of persons with impaired host defenses; and changes in the way that food is processed and distributed. Several recent health events underscore the need for a public health system ready to address whatever disease problems that might arise. For example, in 1997, an avian strain of influenza that had never before infected humans began to kill previously healthy persons in Hong Kong, and strains of Sta phylococcus aureus with diminished susceptibility to the antibiotic vancomycin were reported in Japan and the United States. In addition, researchers recently discovered that a strain of the virus that causes acquired immunodeficiency syndrome (AIDS) had been infecting humans for at least 20 years before AIDS emerged as a worldwide epidemic. Preventing Emerging Infectious Diseases: A Strategy for the 21st Century describes CDC's plan to combat today's infectious diseases and prevent those of tomorrow. It represents the second phase of the effort launched in 1994 with the publication of CDC's Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States. This overview of the updated plan outlines specific objectives under four major goals: a) surveillance and response, b) applied research, c) infrastructure and training, and d) prevention and control. Achieving these objectives will enhance understanding of infectious diseases and bolster their detection

  8. Insight into "Calculated Risk": An Application to the Prioritization of Emerging Infectious Diseases for Blood Transfusion Safety.

    PubMed

    Neslo, R E J; Oei, W; Janssen, M P

    2017-02-23

    Increasing identification of transmissions of emerging infectious diseases (EIDs) by blood transfusion raised the question which of these EIDs poses the highest risk to blood safety. For a number of the EIDs that are perceived to be a threat to blood safety, evidence on actual disease or transmission characteristics is lacking, which might render measures against such EIDs disputable. On the other hand, the fact that we call them "emerging" implies almost by definition that we are uncertain about at least some of their characteristics. So what is the relative importance of various disease and transmission characteristics, and how are these influenced by the degree of uncertainty associated with their actual values? We identified the likelihood of transmission by blood transfusion, the presence of an asymptomatic phase of infection, prevalence of infection, and the disease impact as the main characteristics of the perceived risk of disease transmission by blood transfusion. A group of experts in the field of infectious diseases and blood transfusion ranked sets of (hypothetical) diseases with varying degrees of uncertainty associated with their disease characteristics, and used probabilistic inversion to obtain probability distributions for the weight of each of these risk characteristics. These distribution weights can be used to rank both existing and newly emerging infectious diseases with (partially) known characteristics. Analyses show that in case there is a lack of data concerning disease characteristics, it is the uncertainty concerning the asymptomatic phase and the disease impact that are the most important drivers of the perceived risk. On the other hand, if disease characteristics are well established, it is the prevalence of infection and the transmissibility of the disease by blood transfusion that will drive the perceived risk. The risk prioritization model derived provides an easy to obtain and rational expert assessment of the relative importance of

  9. [Hybrid management of an infectious pseudoaneurysm. Report of one case].

    PubMed

    Sagüés C, Rodrigo; Soto G, Sebastián

    2011-08-01

    We report a 61-year-old male with a four months history of progressive back pain, fever, weight loss and hematuria. A CAT scan showed a spondylitis with destruction of L1 and L2 vertebral bodies and a big pseudoaneurysm of the posterior wall of the visceral aorta. A hybrid approach was used to repair the lesion in two stages; a surgical superior mesenteric artery revascularization followed by the placement of an endovascular stent graft in the affected segment of the aorta 48 hours later, excluding the lesion from circulation. In the postoperative period, no evidence of mesenteric vascular insufficiency was detected but the patient developed a systemic inflammatory response that was managed adequately. A CAT scan performed one month later confirmed the exclusion of the pseudoaneurysm. One year after surgery, the patient is able to walk and without evidences of infection or pseudoaneurysm.

  10. Climate change influences on marine infectious diseases: implications for management and society

    USGS Publications Warehouse

    Burge, Colleen A.; Eakin, C. Mark; Friedman, Carolyn S.; Froelich, Brett; Hershberger, Paul K.; Hofmann, Eileen E.; Petes, Laura E.; Prager, Katherine C.; Weil, Ernesto; Willis, Bette L.; Ford, Susan E.; Harvell, C. Drew

    2014-01-01

    Infectious diseases are common in marine environments, but the effects of a changing climate on marine pathogens are not well understood. Here, we focus on reviewing current knowledge about how the climate drives hostpathogen interactions and infectious disease outbreaks. Climate-related impacts on marine diseases are being documented in corals, shellfish, finfish, and humans; these impacts are less clearly linked to other organisms. Oceans and people are inextricably linked, and marine diseases can both directly and indirectly affect human health, livelihoods, and well-being. We recommend an adaptive management approach to better increase the resilience of ocean systems vulnerable to marine diseases in a changing climate. Land-based management methods of quarantining, culling, and vaccinating are not successful in the ocean; therefore, forecasting conditions that lead to outbreaks and designing tools/approaches to influence these conditions may be the best way to manage marine disease.

  11. Climate change influences on marine infectious diseases: implications for management and society.

    PubMed

    Burge, Colleen A; Mark Eakin, C; Friedman, Carolyn S; Froelich, Brett; Hershberger, Paul K; Hofmann, Eileen E; Petes, Laura E; Prager, Katherine C; Weil, Ernesto; Willis, Bette L; Ford, Susan E; Harvell, C Drew

    2014-01-01

    Infectious diseases are common in marine environments, but the effects of a changing climate on marine pathogens are not well understood. Here we review current knowledge about how the climate drives host-pathogen interactions and infectious disease outbreaks. Climate-related impacts on marine diseases are being documented in corals, shellfish, finfish, and humans; these impacts are less clearly linked for other organisms. Oceans and people are inextricably linked, and marine diseases can both directly and indirectly affect human health, livelihoods, and well-being. We recommend an adaptive management approach to better increase the resilience of ocean systems vulnerable to marine diseases in a changing climate. Land-based management methods of quarantining, culling, and vaccinating are not successful in the ocean; therefore, forecasting conditions that lead to outbreaks and designing tools/approaches to influence these conditions may be the best way to manage marine disease.

  12. ID-Viewer: a visual analytics architecture for infectious diseases surveillance and response management in Pakistan.

    PubMed

    Ali, M A; Ahsan, Z; Amin, M; Latif, S; Ayyaz, A; Ayyaz, M N

    2016-05-01

    Globally, disease surveillance systems are playing a significant role in outbreak detection and response management of Infectious Diseases (IDs). However, in developing countries like Pakistan, epidemic outbreaks are difficult to detect due to scarcity of public health data and absence of automated surveillance systems. Our research is intended to formulate an integrated service-oriented visual analytics architecture for ID surveillance, identify key constituents and set up a baseline for easy reproducibility of such systems in the future. This research focuses on development of ID-Viewer, which is a visual analytics decision support system for ID surveillance. It is a blend of intelligent approaches to make use of real-time streaming data from Emergency Departments (EDs) for early outbreak detection, health care resource allocation and epidemic response management. We have developed a robust service-oriented visual analytics architecture for ID surveillance, which provides automated mechanisms for ID data acquisition, outbreak detection and epidemic response management. Classification of chief-complaints is accomplished using dynamic classification module, which employs neural networks and fuzzy-logic to categorize syndromes. Standard routines by Center for Disease Control (CDC), i.e. c1-c3 (c1-mild, c2-medium and c3-ultra), and spatial scan statistics are employed for detection of temporal and spatio-temporal disease outbreaks respectively. Prediction of imminent disease threats is accomplished using support vector regression for early warnings and response planning. Geographical visual analytics displays are developed that allow interactive visualization of syndromic clusters, monitoring disease spread patterns, and identification of spatio-temporal risk zones. We analysed performance of surveillance framework using ID data for year 2011-2015. Dynamic syndromic classifier is able to classify chief-complaints to appropriate syndromes with high classification

  13. Current management of surgical oncologic emergencies.

    PubMed

    Bosscher, Marianne R F; van Leeuwen, Barbara L; Hoekstra, Harald J

    2015-01-01

    For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed. A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days. In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%. In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

  14. Emerging tools and technologies in watershed management

    Treesearch

    D. Phillip Guertin; Scott N. Miller; David C. Goodrich

    2000-01-01

    The field of watershed management is highly dependent on spatially distributed data. Over the past decade, significant advances have been made toward the capture, storage, and use of spatial data. Emerging tools and technologies hold great promise for improving the scientific understanding of watershed processes and are already revolutionizing watershed research....

  15. Special Population Planner for Emergency Management

    SciTech Connect

    2003-04-17

    The SPP is a tool for use by emergency management agencies in creating plans for possible events requiring their attention. It incorporates extensive data including those on special needs populations so that this segment of the population will be considered in general plans.

  16. Hanford emergency management plan - release 15

    SciTech Connect

    CARPENTER, G.A.

    1999-07-19

    The Hanford emergency management plan for the US Department of Energy Richland, WA and Office of River Protection. The program was developed in accordance with DOE Orders as well as Federal and State regulations to protect workers and public health and safety.

  17. The infectious diseases impact statement: a mechanism for addressing emerging diseases.

    PubMed Central

    McSweegan, E.

    1996-01-01

    The use of an Infectious Diseases Impact Statement (IDIS) is proposed for predictive assessments of local changes in infectious diseases arising from human-engineered activities. IDIS is intended to be analogous to an Environmental Impact Statement. The drafting of an IDIS for specific activities, particularly in developing nations, would provide a formal mechanism for examining potential changes in local health conditions, including infected and susceptible populations, diseases likely to fluctuate in response to development, existing control measures, and vectors likely to be affected by human activities. The resulting survey data could provide a rational basis and direction for development, surveillance, and prevention measures. An IDIS process that balances environmental alterations, local human health, and economic growth could substantially alter the nature of international development efforts and infectious disease outbreaks. PMID:8903209

  18. The infectious diseases impact statement: a mechanism for addressing emerging diseases.

    PubMed

    McSweegan, E

    1996-01-01

    The use of an Infectious Diseases Impact Statement (IDIS) is proposed for predictive assessments of local changes in infectious diseases arising from human-engineered activities. IDIS is intended to be analogous to an Environmental Impact Statement. The drafting of an IDIS for specific activities, particularly in developing nations, would provide a formal mechanism for examining potential changes in local health conditions, including infected and susceptible populations, diseases likely to fluctuate in response to development, existing control measures, and vectors likely to be affected by human activities. The resulting survey data could provide a rational basis and direction for development, surveillance, and prevention measures. An IDIS process that balances environmental alterations, local human health, and economic growth could substantially alter the nature of international development efforts and infectious disease outbreaks.

  19. Standardized emergency management system and response to a smallpox emergency.

    PubMed

    Kim-Farley, Robert J; Celentano, John T; Gunter, Carol; Jones, Jessica W; Stone, Rogelio A; Aller, Raymond D; Mascola, Laurene; Grigsby, Sharon F; Fielding, Jonathan E

    2003-01-01

    The smallpox virus is a high-priority, Category-A agent that poses a global, terrorism security risk because it: (1) easily can be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential for a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. In recognition of this risk, the Los Angeles County Department of Health Services (LAC-DHS) developed the Smallpox Preparedness, Response, and Recovery Plan for LAC to prepare for the possibility of an outbreak of smallpox. A unique feature of the LAC-DHS plan is its explicit use of the Standardized Emergency Management System (SEMS) framework for detailing the functions needed to respond to a smallpox emergency. The SEMS includes the Incident Command System (ICS) structure (management, operations, planning/intelligence, logistics, and finance/administration), the mutual-aid system, and the multi/interagency coordination required during a smallpox emergency. Management for incident command includes setting objectives and priorities, information (risk communications), safety, and liaison. Operations includes control and containment of a smallpox outbreak including ring vaccination, mass vaccination, adverse events monitoring and assessment, management of confirmed and suspected smallpox cases, contact tracing, active surveillance teams and enhanced hospital-based surveillance, and decontamination. Planning/intelligence functions include developing the incident action plan, epidemiological investigation and analysis of smallpox cases, and epidemiological assessment of the vaccination coverage status of populations at risk. Logistics functions include receiving, handling, inventorying, and distributing smallpox vaccine and vaccination clinic supplies; personnel; transportation; communications; and health care of personnel. Finally, finance/administration functions include monitoring

  20. Federal Emergency Management Information System (FEMIS). Data management guide

    SciTech Connect

    Burnett, R.A.; Downing, T.R.; Gaustad, K.L.

    1997-11-21

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that is being developed under the direction of the U.S. Army Chemical and Biological Defense Command. This Data Management Guide provides the background, operations, and procedures needed to generate and maintain the data resources in the system. Information required to manage the data files and database used to support the administrative, user-environment, database management, and operational capabilities of the system are provided. This document provides a description of the relational and spatial information present in FEMIS. It describes how the data was assembled, how it is loaded, and how it is managed while the system is in operation.

  1. Impacts of biodiversity on the emergence and transmission of infectious diseases.

    PubMed

    Keesing, Felicia; Belden, Lisa K; Daszak, Peter; Dobson, Andrew; Harvell, C Drew; Holt, Robert D; Hudson, Peter; Jolles, Anna; Jones, Kate E; Mitchell, Charles E; Myers, Samuel S; Bogich, Tiffany; Ostfeld, Richard S

    2010-12-02

    Current unprecedented declines in biodiversity reduce the ability of ecological communities to provide many fundamental ecosystem services. Here we evaluate evidence that reduced biodiversity affects the transmission of infectious diseases of humans, other animals and plants. In principle, loss of biodiversity could either increase or decrease disease transmission. However, mounting evidence indicates that biodiversity loss frequently increases disease transmission. In contrast, areas of naturally high biodiversity may serve as a source pool for new pathogens. Overall, despite many remaining questions, current evidence indicates that preserving intact ecosystems and their endemic biodiversity should generally reduce the prevalence of infectious diseases.

  2. Quantifying trends in disease impact to produce a consistent and reproducible definition of an emerging infectious disease.

    PubMed

    Funk, Sebastian; Bogich, Tiffany L; Jones, Kate E; Kilpatrick, A Marm; Daszak, Peter

    2013-01-01

    The proper allocation of public health resources for research and control requires quantification of both a disease's current burden and the trend in its impact. Infectious diseases that have been labeled as "emerging infectious diseases" (EIDs) have received heightened scientific and public attention and resources. However, the label 'emerging' is rarely backed by quantitative analysis and is often used subjectively. This can lead to over-allocation of resources to diseases that are incorrectly labelled "emerging," and insufficient allocation of resources to diseases for which evidence of an increasing or high sustained impact is strong. We suggest a simple quantitative approach, segmented regression, to characterize the trends and emergence of diseases. Segmented regression identifies one or more trends in a time series and determines the most statistically parsimonious split(s) (or joinpoints) in the time series. These joinpoints in the time series indicate time points when a change in trend occurred and may identify periods in which drivers of disease impact change. We illustrate the method by analyzing temporal patterns in incidence data for twelve diseases. This approach provides a way to classify a disease as currently emerging, re-emerging, receding, or stable based on temporal trends, as well as to pinpoint the time when the change in these trends happened. We argue that quantitative approaches to defining emergence based on the trend in impact of a disease can, with appropriate context, be used to prioritize resources for research and control. Implementing this more rigorous definition of an EID will require buy-in and enforcement from scientists, policy makers, peer reviewers and journal editors, but has the potential to improve resource allocation for global health.

  3. Using “Omics” and Integrated Multi-Omics Approaches to Guide Probiotic Selection to Mitigate Chytridiomycosis and Other Emerging Infectious Diseases

    PubMed Central

    Rebollar, Eria A.; Antwis, Rachael E.; Becker, Matthew H.; Belden, Lisa K.; Bletz, Molly C.; Brucker, Robert M.; Harrison, Xavier A.; Hughey, Myra C.; Kueneman, Jordan G.; Loudon, Andrew H.; McKenzie, Valerie; Medina, Daniel; Minbiole, Kevin P. C.; Rollins-Smith, Louise A.; Walke, Jenifer B.; Weiss, Sophie; Woodhams, Douglas C.; Harris, Reid N.

    2016-01-01

    Emerging infectious diseases in wildlife are responsible for massive population declines. In amphibians, chytridiomycosis caused by Batrachochytrium dendrobatidis, Bd, has severely affected many amphibian populations and species around the world. One promising management strategy is probiotic bioaugmentation of antifungal bacteria on amphibian skin. In vivo experimental trials using bioaugmentation strategies have had mixed results, and therefore a more informed strategy is needed to select successful probiotic candidates. Metagenomic, transcriptomic, and metabolomic methods, colloquially called “omics,” are approaches that can better inform probiotic selection and optimize selection protocols. The integration of multiple omic data using bioinformatic and statistical tools and in silico models that link bacterial community structure with bacterial defensive function can allow the identification of species involved in pathogen inhibition. We recommend using 16S rRNA gene amplicon sequencing and methods such as indicator species analysis, the Kolmogorov–Smirnov Measure, and co-occurrence networks to identify bacteria that are associated with pathogen resistance in field surveys and experimental trials. In addition to 16S amplicon sequencing, we recommend approaches that give insight into symbiont function such as shotgun metagenomics, metatranscriptomics, or metabolomics to maximize the probability of finding effective probiotic candidates, which can then be isolated in culture and tested in persistence and clinical trials. An effective mitigation strategy to ameliorate chytridiomycosis and other emerging infectious diseases is necessary; the advancement of omic methods and the integration of multiple omic data provide a promising avenue toward conservation of imperiled species. PMID:26870025

  4. Perceptions and behaviours of infectious diseases physicians when managing urinary tract infections due to MDR organisms

    PubMed Central

    Trevino, Sergio E.; Babcock, Hilary M.; Henderson, Jeffrey P.; Lane, Michael A.; Beekmann, Susan E.; Polgreen, Philip M.; Marschall, Jonas

    2015-01-01

    Objectives The objective of this study was to attain a better understanding of infectious diseases (ID) physicians' experience with MDR organism (MDRO) urinary tract infections (UTIs) by means of a survey on disease perception, diagnostic management and treatment preferences. Methods A nine-question survey was developed and distributed to members of the North American Emerging Infections Network (EIN) in September 2013. Results Seven hundred and fourteen out of 1461 EIN members responded to the survey (49%). The responses of 603 responders were studied. Most providers perceived an increase in the incidence of MDRO UTIs over the past 3 years (75% of adult ID responders and 63% of paediatric ID responders). One hundred and thirty-four (22%) responders prefer intravenous over oral administration of antimicrobials when both are available, 171 (28%) prefer longer durations of therapy when comparing an MDRO with a susceptible isolate of the same species and 142 (24%) order a repeat urine culture as ‘proof of cure’ after treating an MDRO UTI. Nevertheless, 530 (88%) responders perceived MDRO UTIs to be of similar severity as non-MDRO UTIs. Fifty-five percent of providers prescribed fosfomycin for MDRO UTI at least once; the most common prescribing pattern (among a wide spectrum of approaches) was a single dose (16%). Conclusions Future studies on MDRO UTIs should clarify the role of resistance in patient outcomes and the comparative efficacy of different antimicrobials. Of particular interest is fosfomycin, which is unrelated to other antibiotic classes and may take a more prominent role in treating MDRO cystitis. PMID:26349519

  5. Using social media for disaster emergency management

    NASA Astrophysics Data System (ADS)

    Wang, Y. D.; Wang, T.; Ye, X. Y.; Zhu, J. Q.; Lee, J.

    2016-06-01

    Social media have become a universal phenomenon in our society (Wang et al., 2012). As a new data source, social media have been widely used in knowledge discovery in fields related to health (Jackson et al., 2014), human behaviour (Lee, 2014), social influence (Hong, 2013), and market analysis (Hanna et al., 2011). In this paper, we report a case study of the 2012 Beijing Rainstorm to investigate how emergency information was timely distributed using social media during emergency events. We present a classification and location model for social media text streams during emergency events. This model classifies social media text streams based on their topical contents. Integrated with a trend analysis, we show how Sina-Weibo fluctuated during emergency events. Using a spatial statistical analysis method, we found that the distribution patterns of Sina-Weibo were related to the emergency events but varied among different topics. This study helps us to better understand emergency events so that decision-makers can act on emergencies in a timely manner. In addition, this paper presents the tools, methods, and models developed in this study that can be used to work with text streams from social media in the context of disaster management.

  6. Social media use in emergency management.

    PubMed

    Wukich, Clayton

    2015-01-01

    To identify and illustrate the range of strategies and tactics available for emergency managers using social media. This study uses content analysis of more than 80 related journal articles, research reports, and government documents as well as more than 120 newspaper articles, identified through LexisNexis search queries. Three strategies, information dissemination, monitoring real-time data, and engaging the public in a conversation and/or crowdsourcing, are available to emergency managers to augment communication practices via face-to-face contact and through traditional media outlets. Academic research has identified several message types disseminated during response operations.(1,2) Message types during other emergency phases have received less attention; however, news reporting and government reports provide best practices and inform this study. This article provides the foundation for a more complete typology of emergency management messages. Relatedly, despite limited attention in the academic research, monitoring social media feeds to accrue situational awareness and interacting with others to generate a conversation and/or to coordinate collective action also take place in various forms and are discussed. Findings integrate the fragmented body of knowledge into a more coherent whole and suggest that practitioners might maximize outcomes through a three-step process of information dissemination, data monitoring, and the direct engagement of diverse sets of actors to spur risk reduction efforts. However, these steps require time, personnel, and resources, which present obstacles for agencies operating under conditions of personnel and resource scarcity.

  7. Barriers to managing TB in emergency departments.

    PubMed

    Morton, Rachel

    Improved management of tuberculosis is a key priority for Public Health England due to unacceptably high rates of the disease in the UK, particularly in London and other major cities. A survey of 20 staff in the acute medical unit at Queen Alexandra Hospital, Portsmouth, explored potential barriers to early TB detection and infection control in busy emergency departments. Low awareness and little familiarity with TB among many emergency admissions staff increased the likelihood of transmission from undiagnosed patients in crowded waiting areas. The study suggested regular updates on TB so staff could refresh their knowledge and awareness, and help improve TB detection and infection control.

  8. Hazard analysis of critical control points assessment as a tool to respond to emerging infectious disease outbreaks.

    PubMed

    Edmunds, Kelly L; Hunter, Paul R; Few, Roger; Bell, Diana J

    2013-01-01

    Highly pathogenic avian influenza virus (HPAI) strain H5N1 has had direct and indirect economic impacts arising from direct mortality and control programmes in over 50 countries reporting poultry outbreaks. HPAI H5N1 is now reported as the most widespread and expensive zoonotic disease recorded and continues to pose a global health threat. The aim of this research was to assess the potential of utilising Hazard Analysis of Critical Control Points (HACCP) assessments in providing a framework for a rapid response to emerging infectious disease outbreaks. This novel approach applies a scientific process, widely used in food production systems, to assess risks related to a specific emerging health threat within a known zoonotic disease hotspot. We conducted a HACCP assessment for HPAI viruses within Vietnam's domestic poultry trade and relate our findings to the existing literature. Our HACCP assessment identified poultry flock isolation, transportation, slaughter, preparation and consumption as critical control points for Vietnam's domestic poultry trade. Introduction of the preventative measures highlighted through this HACCP evaluation would reduce the risks posed by HPAI viruses and pressure on the national economy. We conclude that this HACCP assessment provides compelling evidence for the future potential that HACCP analyses could play in initiating a rapid response to emerging infectious diseases.

  9. Evaluation of the certificate in emerging infectious disease research and the certificate in one health training programs, University of Florida.

    PubMed

    Valentine, Marissa A; Perdue, Christopher L; Cummings, James F; Smith, Jacqueline C; Gray, Gregory C

    2015-03-01

    In developing countries, public health professionals and scientists need targeted training and practical skills to respond to global emerging infectious disease threats. The Certificate in Emerging Infectious Disease Research was developed in 2008 to aid such professionals to respond to complex emerging disease problems. The short-course was modified slightly in 2013 and renamed the Certificate in One Health. To evaluate the immediate impact of the short-course, an online survey of 176 past participants from both the courses was conducted. The survey tool assessed the program's process, impact, and outcome measures respectively via assessing the courses' perceived strengths and weaknesses, perceived skills gained, and the participants' current position, publication status, funding status, and educational attainment; 85 (48.3%) participants completed the survey. Reported program strengths included the curriculum, expertise of lecturers, and diversity of the training cohort. The principal reported weakness was the compressed academic schedule. The most frequently reported benefits included: epidemiological and biostatistical skills, followed by One-Health knowledge, and research skills. Twenty-eight percent of the survey respondents reported publishing one or more manuscripts since completing the course and 21% reported receiving research funding. The course appears to have had a positive, immediate impact on the students' self-perceived knowledge and capabilities. Copyright © 2014 Ministry of Health, Saudi Arabia. All rights reserved.

  10. Emergency department management of selected orthopedic injuries.

    PubMed

    Newton, Edward J; Love, John

    2007-08-01

    Rather than providing an encyclopedic review of extremity injuries, this article reviews selected serious injuries of the extremities that can be missed in the emergency department, either because they are relatively uncommon or because they are subtle in their clinical and radiographic presentation. They include injuries to the scapula, the shoulder, the forearm, the femur and hip, the knee, the tibia (which is the most common long bone fracture), and the ankle and foot. Their various causes include sports injuries, falls, and motor vehicle accidents. Several of these injuries can result in emergent complications or have time-dependent outcomes. Consequently, these injuries often must be managed by emergency physicians before specialist expertise becomes available.

  11. ARAC: A support capability for emergency managers

    SciTech Connect

    Pace, J.C.; Sullivan, T.J.; Baskett, R.L.

    1995-08-01

    This paper is intended to introduce to the non-radiological emergency management community the 20-year operational history of the Atmospheric Release Advisory Capability (ARAC), its concept of operations, and its applicability for use in support of emergency management decision makers. ARAC is a centralized federal facility for assessing atmospheric releases of hazardous materials in real time, using a robust suite of three-dimensional atmospheric transport and diffusion models, extensive geophysical and source-description databases, automated meteorological data acquisition systems, and experienced staff members. Although originally conceived to respond to nuclear accidents, the ARAC system has proven to be extremely adaptable, and has been used successfully during a wide variety of nonradiological hazardous chemical situations. ARAC represents a proven, validated, operational support capability for atmospheric hazardous releases.

  12. Emergency Management Computer-Aided Trainer (EMCAT)

    NASA Technical Reports Server (NTRS)

    Rodriguez, R. C.; Johnson, R. P.

    1986-01-01

    The Emergency Management Computer-Aided Trainer (EMCAT) developed by Essex Corporation or NASA and the Federal Emergency Management Administration's (FEMA) National Fire Academy (NFA) is described. It is a computer based training system for fire fighting personnel. A prototype EMCAT system was developed by NASA first using video tape images and then video disk images when the technology became available. The EMCAT system is meant to fill the training needs of the fire fighting community with affordable state-of-the-art technologies. An automated real time simulation of the fire situation was needed to replace the outdated manual training methods currently being used. In order to be successful, this simulator had to provide realism, be user friendly, be affordable, and support multiple scenarios. The EMCAT system meets these requirements and therefore represents an innovative training tool, not only for the fire fighting community, but also for the needs of other disciplines.

  13. Building public confidence in emergency management.

    PubMed

    Pearce, Tony

    2016-01-01

    Over the years the State of Victoria has suffered many disasters, some of them resulting in extensive community, economic and environmental loss. A number of significant events, including the 2009 Victorian bushfires, major flood events in 2010-11 and their subsequent inquiries have resulted in the biggest overhaul of Victoria's emergency management arrangements since 1983. One significant element of the new arrangements is the inclusion of an entity whose role it is to assure the emergency management arrangements at the system level--the first time such a role has existed. This paper will describe the reform programme currently underway in Victoria, as well as the governance and structural arrangements that have been put in place, before detailing the assurance processes that are being implemented.

  14. Evolution and emergence of infectious diseases in theoretical and real-world networks

    PubMed Central

    Leventhal, Gabriel E.; Hill, Alison L.; Nowak, Martin A.; Bonhoeffer, Sebastian

    2015-01-01

    One of the most important advancements in theoretical epidemiology has been the development of methods that account for realistic host population structure. The central finding is that heterogeneity in contact networks, such as the presence of ‘superspreaders’, accelerates infectious disease spread in real epidemics. Disease control is also complicated by the continuous evolution of pathogens in response to changing environments and medical interventions. It remains unclear, however, how population structure influences these adaptive processes. Here we examine the evolution of infectious disease in empirical and theoretical networks. We show that the heterogeneity in contact structure, which facilitates the spread of a single disease, surprisingly renders a resident strain more resilient to invasion by new variants. Our results suggest that many host contact structures suppress invasion of new strains and may slow disease adaptation. These findings are important to the natural history of disease evolution and the spread of drug-resistant strains. PMID:25592476

  15. [Mandatory disclosure and infectious disease. From "pestilential" disease to "emerging" diseases].

    PubMed

    Antoniotti, S; Pellissier, V; Siméoni, M C; Manuel, C

    2002-06-01

    Due to the recent overhaul of the procedure on mandatory disclosure of infectious diseases (law relating to the reinforcement of sanitation quality control established in July 1998, and the May 1999 and May 2001 decrees on the application of this law), wishing to take advantage of this opportunity, the authors propose a chronological review retracing the history of these legal declarations. For over a century, they have represented the main instrument used for intervention and surveillance allowing for the fight against infectious diseases. The health options kept have varied over the years, as well as the precautions taken to respect secrecy (nominative or anonymous disclosure, modalities of transmission...). Procedures adopted to reconcile the principle of confidentiality along with the necessity to protect public health in the case where it would require an immediate and urgent intervention are examined throughout the chronology (determining the source of contamination, prevention of contagion).

  16. Current Management of Surgical Oncologic Emergencies

    PubMed Central

    Bosscher, Marianne R. F.; van Leeuwen, Barbara L.; Hoekstra, Harald J.

    2015-01-01

    Objectives For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed. Method A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days. Results In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%. Conclusion In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy. PMID:25933135

  17. Emergency Management. Functional Area Qualification Standard

    DTIC Science & Technology

    2004-01-01

    TS DOE– STD –1177-2004 January 2004 DOE STANDARD EMERGENCY MANAGEMENT FUNCTIONAL AREA QUALIFICATION STANDARD...unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 DOE- STD -1177-2004 i This document has been reproduced directly from...Service, Springfield, VA 22161; (703) 605–6000. DOE- STD -1177-2004 ii APPROVAL The Federal Technical Capability Panel consists of senior U.S

  18. Social Media in Emergency Management: Capability Assessment

    DTIC Science & Technology

    2014-05-01

    mobile.”[9] The prevalence of tablet computers and smartphones has led to a surge in mobile applications (apps), including location-based information...some emergency management and humanitarian relief organizations, such as the Canadian Red Cross6 and FEMA7. For example, one of the smartphone apps... smartphone -app DRDC-RDDC-2014-R16 5 for humor & levity; for information seeking; for timely information; for unfiltered information; to determine

  19. Data-model fusion to better understand emerging pathogens and improve infectious disease forecasting.

    PubMed

    LaDeau, Shannon L; Glass, Gregory E; Hobbs, N Thompson; Latimer, Andrew; Ostfeld, Richard S

    2011-07-01

    Ecologists worldwide are challenged to contribute solutions to urgent and pressing environmental problems by forecasting how populations, communities, and ecosystems will respond to global change. Rising to this challenge requires organizing ecological information derived from diverse sources and formally assimilating data with models of ecological processes. The study of infectious disease has depended on strategies for integrating patterns of observed disease incidence with mechanistic process models since John Snow first mapped cholera cases around a London water pump in 1854. Still, zoonotic and vector-borne diseases increasingly affect human populations, and methods used to successfully characterize directly transmitted diseases are often insufficient. We use four case studies to demonstrate that advances in disease forecasting require better understanding of zoonotic host and vector populations, as well of the dynamics that facilitate pathogen amplification and disease spillover into humans. In each case study, this goal is complicated by limited data, spatiotemporal variability in pathogen transmission and impact, and often, insufficient biological understanding. We present a conceptual framework for data-model fusion in infectious disease research that addresses these fundamental challenges using a hierarchical state-space structure to (1) integrate multiple data sources and spatial scales to inform latent parameters, (2) partition uncertainty in process and observation models, and (3) explicitly build upon existing ecological and epidemiological understanding. Given the constraints inherent in the study of infectious disease and the urgent need for progress, fusion of data and expertise via this type of conceptual framework should prove an indispensable tool.

  20. Multi-Criteria Decision Analysis Tools for Prioritising Emerging or Re-Emerging Infectious Diseases Associated with Climate Change in Canada

    PubMed Central

    Cox, Ruth; Sanchez, Javier; Revie, Crawford W.

    2013-01-01

    Global climate change is known to result in the emergence or re-emergence of some infectious diseases. Reliable methods to identify the infectious diseases of humans and animals and that are most likely to be influenced by climate are therefore required. Since different priorities will affect the decision to address a particular pathogen threat, decision makers need a standardised method of prioritisation. Ranking methods and Multi-Criteria Decision approaches provide such a standardised method and were employed here to design two different pathogen prioritisation tools. The opinion of 64 experts was elicited to assess the importance of 40 criteria that could be used to prioritise emerging infectious diseases of humans and animals in Canada. A weight was calculated for each criterion according to the expert opinion. Attributes were defined for each criterion as a transparent and repeatable method of measurement. Two different Multi-Criteria Decision Analysis tools were tested, both of which used an additive aggregation approach. These were an Excel spreadsheet tool and a tool developed in software ‘M-MACBETH’. The tools were trialed on nine ‘test’ pathogens. Two different methods of criteria weighting were compared, one using fixed weighting values, the other using probability distributions to account for uncertainty and variation in expert opinion. The ranking of the nine pathogens varied according to the weighting method that was used. In both tools, using both weighting methods, the diseases that tended to rank the highest were West Nile virus, Giardiasis and Chagas, while Coccidioidomycosis tended to rank the lowest. Both tools are a simple and user friendly approach to prioritising pathogens according to climate change by including explicit scoring of 40 criteria and incorporating weighting methods based on expert opinion. They provide a dynamic interactive method that can help to identify pathogens for which a full risk assessment should be pursued

  1. Infectious Disease Management through Point-of-Care Personalized Medicine Molecular Diagnostic Technologies.

    PubMed

    Bissonnette, Luc; Bergeron, Michel G

    2012-05-02

    Infectious disease management essentially consists in identifying the microbial cause(s) of an infection, initiating if necessary antimicrobial therapy against microbes, and controlling host reactions to infection. In clinical microbiology, the turnaround time of the diagnostic cycle (>24 hours) often leads to unnecessary suffering and deaths; approaches to relieve this burden include rapid diagnostic procedures and more efficient transmission or interpretation of molecular microbiology results. Although rapid nucleic acid-based diagnostic testing has demonstrated that it can impact on the transmission of hospital-acquired infections, we believe that such life-saving procedures should be performed closer to the patient, in dedicated 24/7 laboratories of healthcare institutions, or ideally at point of care. While personalized medicine generally aims at interrogating the genomic information of a patient, drug metabolism polymorphisms, for example, to guide drug choice and dosage, personalized medicine concepts are applicable in infectious diseases for the (rapid) identification of a disease-causing microbe and determination of its antimicrobial resistance profile, to guide an appropriate antimicrobial treatment for the proper management of the patient. The implementation of point-of-care testing for infectious diseases will require acceptance by medical authorities, new technological and communication platforms, as well as reimbursement practices such that time- and life-saving procedures become available to the largest number of patients.

  2. Infectious Disease Management through Point-of-Care Personalized Medicine Molecular Diagnostic Technologies

    PubMed Central

    Bissonnette, Luc; Bergeron, Michel G.

    2012-01-01

    Infectious disease management essentially consists in identifying the microbial cause(s) of an infection, initiating if necessary antimicrobial therapy against microbes, and controlling host reactions to infection. In clinical microbiology, the turnaround time of the diagnostic cycle (>24 hours) often leads to unnecessary suffering and deaths; approaches to relieve this burden include rapid diagnostic procedures and more efficient transmission or interpretation of molecular microbiology results. Although rapid nucleic acid-based diagnostic testing has demonstrated that it can impact on the transmission of hospital-acquired infections, we believe that such life-saving procedures should be performed closer to the patient, in dedicated 24/7 laboratories of healthcare institutions, or ideally at point of care. While personalized medicine generally aims at interrogating the genomic information of a patient, drug metabolism polymorphisms, for example, to guide drug choice and dosage, personalized medicine concepts are applicable in infectious diseases for the (rapid) identification of a disease-causing microbe and determination of its antimicrobial resistance profile, to guide an appropriate antimicrobial treatment for the proper management of the patient. The implementation of point-of-care testing for infectious diseases will require acceptance by medical authorities, new technological and communication platforms, as well as reimbursement practices such that time- and life-saving procedures become available to the largest number of patients. PMID:25562799

  3. How to find and access information on emerging infectious diseases: Chapter 7 in Disease emergence and resurgence: The wildlife-human connection

    USGS Publications Warehouse

    Wesenberg, Katherine; Friend, Milton

    2006-01-01

    During the last two decades of the 20th century, and continuing today, there has been a global emergence and resurgence of infectious disease of humans and other species. The “exotic” nature and serious consequences of many of these diseases results in media attention and public interest, in addition to the scientific exploration and efforts associated with combating these diseases. Finding and accessing information about diseases and keeping informed about current events and new discoveries is a daunting task because of the diversity of information sources and the great volume of published materials. This chapter provides guidance for effectively traveling the information highway and efficiently negotiating the information maze.

  4. Risk communication as a core public health competence in infectious disease management: Development of the ECDC training curriculum and programme.

    PubMed

    Dickmann, Petra; Abraham, Thomas; Sarkar, Satyajit; Wysocki, Piotr; Cecconi, Sabrina; Apfel, Franklin; Nurm, Ülla-Karin

    2016-01-01

    Risk communication has been identified as a core competence for guiding public health responses to infectious disease threats. The International Health Regulations (2005) call for all countries to build capacity and a comprehensive understanding of health risks before a public health emergency to allow systematic and coherent communication, response and management. Research studies indicate that while outbreak and crisis communication concepts and tools have long been on the agenda of public health officials, there is still a need to clarify and integrate risk communication concepts into more standardised practices and improve risk communication and health, particularly among disadvantaged populations. To address these challenges, the European Centre for Disease Prevention and Control (ECDC) convened a group of risk communication experts to review and integrate existing approaches and emerging concepts in the development of a training curriculum. This curriculum articulates a new approach in risk communication moving beyond information conveyance to knowledge- and relationship-building. In a pilot training this approach was reflected both in the topics addressed and in the methods applied. This article introduces the new conceptual approach to risk communication capacity building that emerged from this process, presents the pilot training approach developed, and shares the results of the course evaluation.

  5. Model Selection and Evaluation Based on Emerging Infectious Disease Data Sets including A/H1N1 and Ebola

    PubMed Central

    Liu, Wendi; Tang, Sanyi; Xiao, Yanni

    2015-01-01

    The aim of the present study is to apply simple ODE models in the area of modeling the spread of emerging infectious diseases and show the importance of model selection in estimating parameters, the basic reproduction number, turning point, and final size. To quantify the plausibility of each model, given the data and the set of four models including Logistic, Gompertz, Rosenzweg, and Richards models, the Bayes factors are calculated and the precise estimates of the best fitted model parameters and key epidemic characteristics have been obtained. In particular, for Ebola the basic reproduction numbers are 1.3522 (95% CI (1.3506, 1.3537)), 1.2101 (95% CI (1.2084, 1.2119)), 3.0234 (95% CI (2.6063, 3.4881)), and 1.9018 (95% CI (1.8565, 1.9478)), the turning points are November 7,November 17, October 2, and November 3, 2014, and the final sizes until December 2015 are 25794 (95% CI (25630, 25958)), 3916 (95% CI (3865, 3967)), 9886 (95% CI (9740, 10031)), and 12633 (95% CI (12515, 12750)) for West Africa, Guinea, Liberia, and Sierra Leone, respectively. The main results confirm that model selection is crucial in evaluating and predicting the important quantities describing the emerging infectious diseases, and arbitrarily picking a model without any consideration of alternatives is problematic. PMID:26451161

  6. Critical Care Medicine and Infectious Diseases: An Emerging Combined Subspecialty in the United States.

    PubMed

    Kadri, Sameer S; Rhee, Chanu; Fortna, Gregory S; O'Grady, Naomi P

    2015-08-15

    The recent rise in unfilled training positions among infectious diseases (ID) fellowship programs nationwide indicates that ID is declining as a career choice among internal medicine residency graduates. Supplementing ID training with training in critical care medicine (CCM) might be a way to regenerate interest in the specialty. Hands-on patient care and higher salaries are obvious attractions. High infection prevalence and antibiotic resistance in intensive care units, expanding immunosuppressed host populations, and public health crises such as the recent Ebola outbreak underscore the potential synergy of CCM-ID training. Most intensivists receive training in pulmonary medicine and only 1% of current board-certified intensivists are trained in ID. While still small, this cohort of CCM-ID certified physicians has continued to rise over the last 2 decades. ID and CCM program leadership nationwide must recognize these trends and the merits of the CCM-ID combination to facilitate creation of formal dual-training opportunities. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  7. [Climate changes and emerging diseases. What new infectious diseases and health problem can be expected?].

    PubMed

    Stark, K; Niedrig, M; Biederbick, W; Merkert, H; Hacker, J

    2009-07-01

    Increasing temperatures, but also other climatic factors, will have an impact on human health. Apart from the direct consequences of extreme weather conditions (e.g., heat-related fatalities), indirect health consequences in the long-term are also of great importance. In addition to a likely increase in allergic diseases and additional complications in the course of cardiovascular and respiratory diseases, infectious diseases are of particular interest. In Germany, endemic pathogens, such as hantavirus (with its reservoir in small rodents), tick-borne pathogens (Borrelia burgdorferi, tick-borne encephalitis virus), and certain food- and water-borne pathogens, are of concern. Mild winters favor rodent populations and may result in hantavirus epidemics in the subsequent summer period. Statistical analyses show a significant association between temperature and campylobacter incidence in Germany. An outbreak of rodent-borne leptospirosis among strawberry harvesters enhanced by heavy rainfalls illustrates how weather conditions may influence disease occurrence. Pathogens that are non-endemic in Germany but are imported by humans, vectors, and reservoir animals pose an additional risk to the population. Increasing temperatures improve the conditions for establishment of new vectors and for autochthonous transmission of some pathogens (e.g., chikungunya, dengue, West Nile virus, malaria, or leishmaniasis). Climatic and ecologic conditions in Germany currently do not favor autochthonous outbreaks for most of these pathogens. However, if temperatures increase, as expected, such outbreaks will become more likely. Germany should enhance its research in public health activities in the field of climate change and infectious diseases.

  8. Emerging role of infectious etiologies in the pathogenesis of marginal zone B-cell lymphomas.

    PubMed

    Zucca, Emanuele; Bertoni, Francesco; Vannata, Barbara; Cavalli, Franco

    2014-10-15

    Extranodal marginal zone B-cell lymphomas of the mucosa-associated lymphoid tissue (MALT) arise from lymphoid populations that are induced by chronic inflammation in extranodal sites. The most frequently affected organ is the stomach, where MALT lymphoma is incontrovertibly associated with a chronic gastritis induced by a microbial pathogen, Helicobacter pylori. Gastric MALT lymphoma therefore represents a paradigm for evaluating inflammation-associated lymphomagenesis, which may lead to a deeper understanding of a possible etiologic association between other microorganisms and nongastric marginal zone lymphomas. Besides infectious etiology, chronic inflammation caused by autoimmune diseases, such as Sjögren syndrome or Hashimoto thyroiditis, can also carry a significant risk factor for the development of marginal zone lymphoma. In addition to the continuous antigenic drive, additional oncogenic events play a relevant role in lymphoma growth and progression to the point at which the lymphoproliferative process may eventually become independent of antigenic stimulation. Recent studies on MALT lymphomas have in fact demonstrated genetic alterations affecting the NF-κB) pathway, a major signaling pathway involved in many cancers. This review aims to present marginal zone lymphoma as an example of the close pathogenetic link between chronic inflammation and tumor development, with particular attention to the role of infectious agents and the integration of these observations into everyday clinical practice. See all articles in this CCR Focus section, "Paradigm Shifts in Lymphoma."

  9. This issue: Managing emergencies part 2.

    PubMed

    Ralston, Mark E

    2005-12-01

    Pediatric toxicologic exposures are common, and the primary care pediatric practitioner must be prepared to handle emergencies related to poisoning and overdose in children and adolescents. Fortunately, many poisonings in children are unintentional, preventable, and benign. For both simple and complex cases, help is available to medical professionals 24/7 from multiple sources, including an improved toxic exposure database, new research, the network of Certified Specialists in Poison Information at our nation's regional poison control centers, and backup medical and clinical toxicologists. The US system of AAPCC-certified poison control centers has been appropriately labeled "a national safety net" serving the public and medical practitioners in the management of pediatric toxicologic exposures. Increased funding to this system will be critical to update its services for the future, including preparation to detect the increasing threat of new public health emergencies such as chemical and biological terrorist attacks.

  10. A new asset for pathogen informatics--the Enteropathogen Resource Integration Center (ERIC), an NIAID Bioinformatics Resource Center for Biodefense and Emerging/Re-emerging Infectious Disease.

    PubMed

    Greene, John M; Plunkett, Guy; Burland, Valerie; Glasner, Jeremy; Cabot, Eric; Anderson, Brad; Neeno-Eckwall, Eric; Qiu, Yu; Mau, Bob; Rusch, Michael; Liss, Paul; Hampton, Thomas; Pot, David; Shaker, Matthew; Shaull, Lorie; Shetty, Panna; Shi, Chuan; Whitmore, Jon; Wong, Mary; Zaremba, Sam; Blattner, Frederick R; Perna, Nicole T

    2007-01-01

    ERIC (Enteropathogen Resource Information Center) is one of the National Institute of Allergy and Infectious Diseases (NIAID) Bioinformatics Resource Centers for Biodefense and Emerging/Re-emerging Infectious Disease. ERIC serves as a comprehensive information resource for five related pathogens: Yersinia enterocolitica, Yersinia pestis, diarrheagenic E. coli, Shigella spp., and Salmonella spp. ERIC integrates genomics, proteomics, biochemical and microbiological information to facilitate the interpretation and understanding of ERIC pathogens and select related non-pathogens for the advancement of diagnostics, therapeutics, and vaccines. ERIC (www.ericbrc.org) is evolving to provide state-of-the-art analysis tools and data types, such as genome sequencing, comparative genomics, genome polymorphisms, gene expression, proteomics, and pathways as well as expertly curated community genome annotation. Genome sequence and genome annotation data and a variety of analysis and tools for eight strains of Yersinia enterocolitica and Yersinia pestis pathogens (Yersinia pestis biovars Mediaevalis KIM, Mediaevalis 91001, Orientalis CO92, Orientalis IP275, Antiqua Angola, Antiqua Antiqua, Antiqua Nepal516, and Yersinia enterocolitica 8081) and two strains of Yersinia pseudotuberculosis (Yersinia pseudotuberculosis IP32953 and IP31758) are currently available through the ERIC portal. ERIC seeks to maintain a strong collaboration with the scientific community so that we can continue to identify and incorporate the latest research data, tools, and training to best meet the current and future needs of the enteropathogen research community. All tools and data developed under this NIAID contract will be freely available. Please contact info@ericbrc.org for more information.

  11. Computer Simulation for Emergency Incident Management

    SciTech Connect

    Brown, D L

    2004-12-03

    This report describes the findings and recommendations resulting from the Department of Homeland Security (DHS) Incident Management Simulation Workshop held by the DHS Advanced Scientific Computing Program in May 2004. This workshop brought senior representatives of the emergency response and incident-management communities together with modeling and simulation technologists from Department of Energy laboratories. The workshop provided an opportunity for incident responders to describe the nature and substance of the primary personnel roles in an incident response, to identify current and anticipated roles of modeling and simulation in support of incident response, and to begin a dialog between the incident response and simulation technology communities that will guide and inform planned modeling and simulation development for incident response. This report provides a summary of the discussions at the workshop as well as a summary of simulation capabilities that are relevant to incident-management training, and recommendations for the use of simulation in both incident management and in incident management training, based on the discussions at the workshop. In addition, the report discusses areas where further research and development will be required to support future needs in this area.

  12. The configuration management program for the Emergency Management Support System

    SciTech Connect

    Probasco, K M; Stephan, E G

    1991-08-01

    Emergency response software is used increasingly by the US Department of Energy's (DOE's) Emergency Management Project (EMP) personnel at Hanford Site. This software must be reliable, of high quality, and capable of performing critical functions to support assessment of actual or potential consequences of any hazardous accidents onsite or events having potential offsite impacts. To better control the software and ensure its suitability for use as a tool to protect employees, the public, and environment, a method for specifying and certifying its capabilities and documenting its development and implementation was needed. A team of EMP staff, composed of personnel from Pacific Northwest Laboratory (PNL) and Boeing Computer Services- Richland (BCSR) under the direction of PNL EMP, responded to this need by developing a software configuration management program (CMP). This report documents the development of the CMP, including the strategies upon which the CMP is based, and describes the program as it has been implemented for EMS System software. The program relies on the integration of its three primary elements: the configuration management staff, tools, and process. Configuration management staff run the program, using specially designed configuration management forms to guide, document, and track the life cycle of the software. The configuration management process itself is reflected in the instructive forms and summarized in flowcharts representing each phase of the process -- from requirements specification through implementation and maintenance. 7 refs., 9 figs., 1 tab.

  13. Ruptured intracranial tubercular infectious aneurysm secondary to a tuberculoma and its endovascular management.

    PubMed

    Saraf, R; Limaye, U

    2013-04-01

    Tuberculosis remains to be an endemic infectious disease in developing countries. With the increasing incidence of HIV and AIDS, there is further increase in the incidence of tuberculosis. Although CNS involvement by tuberculosis is seen in all age groups, there is a predilection for younger patients. Central nervous system tuberculosis may present as tuberculoma, cerebral abscess or tuberculous meningitis (TBM). Vasculitis secondary to TBM can cause infarcts and rarely aneurysm formation. In TBM there is a thick, gelatinous exudate around the sylvian fissures, basal cisterns. There is a border zone reaction occurring in the surrounding brain tissue. Inflammatory changes occur in the vessel wall of the arteries bathed in the exudate leading to narrowing of the lumen or occlusion by thrombus formation. The vessels at the base of the brain are most severely affected, including the internal carotid artery, proximal middle cerebral artery and perforating vessels of the basal ganglion. In these cases, the infection probably spreads from the adventitia towards the internal elastic lamina, weakening the vessel wall, with subsequent formation of an infectious aneurysm. Intracranial tuberculomas are space-occupying masses of granulomatous tissue that result from haematogenous spread from a distant focus of tuberculous infection. In endemic regions, tuberculomas account for as many as 50% of all intracranial space-occupying lesions. Inflammation in the vessels surrounding the tuberculoma may lead to formation of aneurysms. This case report illustrates an unusual case of intracranial tuberculomas complicated by intralesional haemorrhage due to an infective tubercular aneurysm in its vicinity. The endovascular treatment of these infectious aneurysms is safe, effective and durable. To the best of our knowledge, this is the first case report of a tuberculoma having intracranial haemorrhage on anti-tubercular treatment due to an infectious aneurysm developing in an artery in the

  14. Emerging Contaminant Issues, Including Management Of Emerging Contaminants In Wastewater

    EPA Science Inventory

    Emerging contaminants are receiving increasing media and scientific attention. These chemicals are sometimes referred to as compounds of emerging concern or trace organic compounds, and include several groups of chemicals including endocrine disrupting compounds (EDCs), and pha...

  15. Facial palsy in children: emergency department management and outcome.

    PubMed

    Wang, Cheng-Hsien; Chang, Yu-Che; Shih, Hong-Mo; Chen, Chun-Yu; Chen, Jih-Chang

    2010-02-01

    To describe the characteristics of children who present to an emergency department (ED) with facial palsy and determine the association of outcome with etiology, degree of initial paralysis, and ED management. This was a retrospective cohort study of children who presented to an ED with facial nerve paralysis (FNP). There were 85 patients with a mean age of 8.0 (SD, 6.1) years; 60% (n = 51) of the patients were male, and 65.9% (n = 56) were admitted to the hospital. Bell palsy (50.6%) was the most common etiology followed by infectious (22.4%), traumatic (16.5%), congenital (7.1%), and neoplastic etiologies (3.5%). Patients with Bell palsy had shorter recovery times (P = 0.049), and traumatic cases required a longer time for recovery (P = 0.016). Acute otitis media (AOM)-related pediatric FNP had shorter recovery times than non-AOM-related cases (P = 0.005) in infectious group. Patients given steroid therapy did not have a shorter recovery time (P = 0.237) or a better recovery (P = 0.269). There was no difference in recovery rate of pediatric patients with Bell palsy between hospitalization or not (P = 0.952). Bell palsy, infection, and trauma were most common etiologies of pediatric FNP. Recovery times were shorter in pediatric patients with Bell palsy and AOM-related FNP, whereas recovery took longer in traumatic cases. Steroid therapy did not seem beneficial for pediatric FNP. Hospitalization is not indicated for pediatric patients with Bell palsy.

  16. Operationalising Factors That Explain the Emergence of Infectious Diseases: A Case Study of the Human Campylobacteriosis Epidemic

    PubMed Central

    Strachan, Norval J. C.; Rotariu, Ovidiu; MacRae, Marion; Sheppard, Samuel K.; Smith-Palmer, Alison; Cowden, John; Maiden, Martin C. J.; Forbes, Ken J.

    2013-01-01

    A framework of general factors for infectious disease emergence was made operational for Campylobacter utilising explanatory variables including time series and risk factor data. These variables were generated using a combination of empirical epidemiology, case-case and case-control studies, time series analysis, and microbial sub-typing (source attribution, diversity, genetic distance) to unravel the changing/emerging aetiology of human campylobacteriosis. The study focused on Scotland between 1990–2012 where there was a 75% increase in reported cases that included >300% increase in the elderly and 50% decrease in young children. During this period there were three phases 1990–2000 a 75% rise and a 20% fall to 2006, followed by a 19% resurgence. The rise coincided with expansions in the poultry industry, consumption of chicken, and a shift from rural to urban cases. The post-2000 fall occurred across all groups apart from the elderly and coincided with a drop of the prevalence of Campylobacter in chicken and a higher proportion of rural cases. The increase in the elderly was associated with uptake of proton pump inhibitors. During the resurgence the increase was predominantly in adults and the elderly, again there was increasing use of PPIs and high prevalences in chicken and ruminants. Cases associated with foreign travel during the study also increased from 9% to a peak of 16% in 2006 before falling to an estimated 10% in 2011, predominantly in adults and older children. During all three periods source attribution, genetic distance, and diversity measurements placed human isolates most similar to those in chickens. A combination of emergence factors generic for infectious diseases were responsible for the Campylobacter epidemic. It was possible to use these to obtain a putative explanation for the changes in human disease and the potential to make an informed view of how incidence rates may change in the future. PMID:24278127

  17. Operationalising factors that explain the emergence of infectious diseases: a case study of the human campylobacteriosis epidemic.

    PubMed

    Strachan, Norval J C; Rotariu, Ovidiu; MacRae, Marion; Sheppard, Samuel K; Smith-Palmer, Alison; Cowden, John; Maiden, Martin C J; Forbes, Ken J

    2013-01-01

    A framework of general factors for infectious disease emergence was made operational for Campylobacter utilising explanatory variables including time series and risk factor data. These variables were generated using a combination of empirical epidemiology, case-case and case-control studies, time series analysis, and microbial sub-typing (source attribution, diversity, genetic distance) to unravel the changing/emerging aetiology of human campylobacteriosis. The study focused on Scotland between 1990-2012 where there was a 75% increase in reported cases that included >300% increase in the elderly and 50% decrease in young children. During this period there were three phases 1990-2000 a 75% rise and a 20% fall to 2006, followed by a 19% resurgence. The rise coincided with expansions in the poultry industry, consumption of chicken, and a shift from rural to urban cases. The post-2000 fall occurred across all groups apart from the elderly and coincided with a drop of the prevalence of Campylobacter in chicken and a higher proportion of rural cases. The increase in the elderly was associated with uptake of proton pump inhibitors. During the resurgence the increase was predominantly in adults and the elderly, again there was increasing use of PPIs and high prevalences in chicken and ruminants. Cases associated with foreign travel during the study also increased from 9% to a peak of 16% in 2006 before falling to an estimated 10% in 2011, predominantly in adults and older children. During all three periods source attribution, genetic distance, and diversity measurements placed human isolates most similar to those in chickens. A combination of emergence factors generic for infectious diseases were responsible for the Campylobacter epidemic. It was possible to use these to obtain a putative explanation for the changes in human disease and the potential to make an informed view of how incidence rates may change in the future.

  18. Performance of online drug information databases as clinical decision support tools in infectious disease medication management.

    PubMed

    Polen, Hyla H; Zapantis, Antonia; Clauson, Kevin A; Clauson, Kevin Alan; Jebrock, Jennifer; Paris, Mark

    2008-11-06

    Infectious disease (ID) medication management is complex and clinical decision support tools (CDSTs) can provide valuable assistance. This study evaluated scope and completeness of ID drug information found in online databases by evaluating their ability to answer 147 question/answer pairs. Scope scores produced highest rankings (%) for: Micromedex (82.3), Lexi-Comp/American Hospital Formulary Service (81.0), and Medscape Drug Reference (81.0); lowest includes: Epocrates Online Premium (47.0), Johns Hopkins ABX Guide (45.6), and PEPID PDC (40.8).

  19. EMS incident management: emergency medical logistics.

    PubMed

    Maniscalco, P M; Christen, H T

    1999-01-01

    If you had to get x amount of supplies to point A or point B, or both, in 10 minutes, how would you do it? The answer lies in the following steps: 1. Develop a logistics plan. 2. Use emergency management as a partner agency for developing your logistics plan. 3. Implement a push logistics system by determining what supplies/medications and equipment are important. 4. Place mass casualty/disaster caches at key locations for rapid deployment. Have medication/fluid caches available at local hospitals. 5. Develop and implement command caches for key supervisors and managers. 6. Anticipate the logistics requirements of a terrorism/tactical violence event based on a community threat assessment. 7. Educate the public about preparing a BLS family disaster kit. 8. Test logistics capabilities at disaster exercises. 9. Budget for logistics needs. 10. Never underestimate the importance of logistics. When logistics support fails, the EMS system fails.

  20. Information systems: key to effective management of civil emergencies

    SciTech Connect

    Giuffrida, L.O.

    1985-01-01

    In fulfilling its goal of ensuring an emergency management capability which can optimize the saving of lives and minimize property damage, the Federal Emergency Management Agency (FEMA) has created an infrastructure and programs which focus on this two-fold task. As an underpinning for this challenging role, an Integrated Emergency Management System (IEMS) has been established on a ''foundation of preparedness and response elements.'' A salient element of the IEMS concept is the National Emergency Management System (NEMS), the key mechanism for information collection, processing, and exchange in support of the nation's emergency management community. 5 references.

  1. Comprehensive psychosocial emergency management promotes recovery.

    PubMed

    Riddell, Killorin; Clouse, Monty

    2004-01-01

    Recently published conclusions erroneously criticize early psychological interventions, and more specifically target critical incident stress debriefing (CISD), as ineffectual responses to human needs following emergencies. The assertions may influence some practitioners to reconsider current commitments to providing early crisis support, or other aspects of early psychological interventions, in the first hours and days after an emergency occurs. The arguments used are misleading in that they confuse the distinctions between CISD and other components of early psychological interventions, and seek to impugn the efficacy of CISD with research findings that have methodological flaws and limited generalizability. Theoretically sound approaches to the phenomenology of earliest reactions and early psychological interventions must build upon survivor and community needs in the aftermath of trauma, and upon an understanding of the psychobiological, evolutionarily-determined aspects of traumatic stress within attachment schema. It is now possible to postulate a broader approach to the early psychosocial needs of persons affected by trauma, whether they are survivors, rescuers, or witnesses. Comprehensive Psychosocial Emergency Management utilizes systematic study of the risk and protective factors within the phenomenology of traumatic stress that disrupt processes which otherwise result in dysfunction. Early psychological intervention enhances coping and resilience, and promotes recovery for all.

  2. Emergency medicine: an operations management view.

    PubMed

    Soremekun, Olan A; Terwiesch, Christian; Pines, Jesse M

    2011-12-01

    Operations management (OM) is the science of understanding and improving business processes. For the emergency department (ED), OM principles can be used to reduce and alleviate the effects of crowding. A fundamental principle of OM is the waiting time formula, which has clear implications in the ED given that waiting time is fundamental to patient-centered emergency care. The waiting time formula consists of the activity time (how long it takes to complete a process), the utilization rate (the proportion of time a particular resource such a staff is working), and two measures of variation: the variation in patient interarrival times and the variation in patient processing times. Understanding the waiting time formula is important because it presents the fundamental parameters that can be managed to reduce waiting times and length of stay. An additional useful OM principle that is applicable to the ED is the efficient frontier. The efficient frontier compares the performance of EDs with respect to two dimensions: responsiveness (i.e., 1/wait time) and utilization rates. Some EDs may be "on the frontier," maximizing their responsiveness at their given utilization rates. However, most EDs likely have opportunities to move toward the frontier. Increasing capacity is a movement along the frontier and to truly move toward the frontier (i.e., improving responsiveness at a fixed capacity), we articulate three possible options: eliminating waste, reducing variability, or increasing flexibility. When conceptualizing ED crowding interventions, these are the major strategies to consider.

  3. [Consensus statement of the National AIDS Plan Secretariat, Spanish Society of Emergency Medicine and AIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology on Emergency and Human Immunodeficiency Virus Infection].

    PubMed

    2013-01-01

    Supporting non-HIV specialist professionals in the treatment of patients with urgent diseases resulting from HIV infection. These recommendations have been agreed by an expert panel from the National AIDS Plan Secretariat, the Spanish Society of Emergency Medicine, and the AIDS Study Group. A review has been made of the safety and efficacy results of clinical trials and cohort studies published in biomedical journals (PubMed and Embase) or presented at conferences. The strength of each recommendation (A, B, C) and the level of supporting evidence (I, II, III) are based on a modification of the criteria of the Infectious Diseases Society of America. The data to be collected from the emergency medical history in order to recognize the patient at risk of HIV infection were specified. It stressed the basic knowledge of ART principles and its importance in terms of decline in morbidity and mortality of HIV+ patients and referring to the HIV specialist for follow-up, where appropriate, including drug interactions. Management of different emergency situations that may occur in patients with HIV infection is also mentioned. The non-HIV specialist professional, will find the necessary tools to approach HIV patients with an emergency disease. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  4. Construction and characterization of a full-length cDNA infectious clone of emerging porcine Senecavirus A.

    PubMed

    Chen, Zhenhai; Yuan, Fangfeng; Li, Yanhua; Shang, Pengcheng; Schroeder, Robin; Lechtenberg, Kelly; Henningson, Jamie; Hause, Benjamin; Bai, Jianfa; Rowland, Raymond R R; Clavijo, Alfonso; Fang, Ying

    2016-10-01

    A full-length cDNA infectious clone, pKS15-01-Clone, was constructed from an emerging Senecavirus A (SVA; strain KS15-01). To explore the potential use as a viral backbone for expressing marker genes, the enhanced green fluorescent protein (EGFP)-tagged reporter virus (vKS15-01-EGFP) was generated using reverse genetics. Compared to the parental virus, the pKS15-01-Clone derived virus (vKS15-01-Clone) replicated efficiently in vitro and in vivo, and induced similar levels of neutralizing antibody and cytokine responses in infected animals. In contrast, the vKS15-01-EGFP virus showed impaired growth ability and induced lower level of immune response in infected animals. Lesions on the dorsal snout and coronary bands were observed in all pigs infected by parental virus KS15-01, but not in pigs infected with vKS15-01-Clone or vKS15-01-EGFP viruses. These results demonstrated that the infectious clone and EGFP reporter virus could be used as important tools in further elucidating the SVA pathogenesis and development of control measures.

  5. Get the news out loudly and quickly: the influence of the media on limiting emerging infectious disease outbreaks.

    PubMed

    Mummert, Anna; Weiss, Howard

    2013-01-01

    During outbreaks of infectious diseases with high morbidity and mortality, individuals closely follow media reports of the outbreak. Many will attempt to minimize contacts with other individuals in order to protect themselves from infection and possibly death. This process is called social distancing. Social distancing strategies include restricting socializing and travel, and using barrier protections. We use modeling to show that for short-term outbreaks, social distancing can have a large influence on reducing outbreak morbidity and mortality. In particular, public health agencies working together with the media can significantly reduce the severity of an outbreak by providing timely accounts of new infections and deaths. Our models show that the most effective strategy to reduce infections is to provide this information as early as possible, though providing it well into the course of the outbreak can still have a significant effect. However, our models for long-term outbreaks indicate that reporting historic infection data can result in more infections than with no reporting at all. We examine three types of media influence and we illustrate the media influence with a simulated outbreak of a generic emerging infectious disease in a small city. Social distancing can never be complete; however, for a spectrum of outbreaks, we show that leaving isolation (stopping applying social distancing measures) for up to 4 hours each day has modest effect on the overall morbidity and mortality.

  6. Timely pain management in the emergency department.

    PubMed

    Patrick, Patricia A; Rosenthal, Barry M; Iezzi, Carina A; Brand, Donald A

    2015-03-01

    Delivering timely pain relief remains a challenge for most emergency departments. To evaluate the effectiveness of a policy aimed at delivering analgesics within 30 min to patients presenting to an emergency department with severe pain. Subjects were aged ≥19 years, had a principal diagnosis of renal colic, hip fracture, or sickle cell disease, reported a pain score ≥8 on a scale of 0 to 10 at triage, and continued to report a score in this range until receiving analgesia. The study compared proportions of patients receiving analgesics within the 30-min target, median time to analgesic administration, and median time to relief of severe pain (decline in pain level to score <8) during 6 months before vs. 6 months after implementation of the new pain management policy. Paradoxically, the median total waiting time to analgesic administration increased from 64 min (n = 75) to 80 min (n = 70) after policy implementation (p = 0.01), and the proportion of patients receiving analgesics within 30 min declined from 17% (13/75) to 7% (5/70) (p = 0.08). Median time to relief of severe pain did not differ significantly between periods (130.5 vs. 153 min; p = 0.31). After implementation of the new pain management policy, the proportion of patients with severe pain receiving analgesics within 30 min actually declined. Although a 30-min target may be unrealistic, it seems reasonable to conclude that something is wrong when patients with notoriously painful conditions must typically wait 1-2 h to obtain relief. Given the millions of individuals who receive care in emergency departments nationwide each year, the suffering caused by delays occurs on a large scale, so creative approaches are clearly needed to overcome the obstacles. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Emergency thoracic ultrasound and clinical risk management

    PubMed Central

    Interrigi, Maria Concetta; Trovato, Francesca M; Catalano, Daniela; Trovato, Guglielmo M

    2017-01-01

    Purpose Thoracic ultrasound (TUS) has been proposed as an easy-option replacement for chest X-ray (CXR) in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. Patients and methods This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. Results Three hundred and seventy emergency TUS scans (excluding trauma patients) were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion); in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed tomography (CT). In seven patients, even if chest disease was identified by CXR, such diagnoses were significantly modified by ultrasound, and CT confirmed that TUS was more appropriate. The overall respective individual performances of CXR and TUS for the diagnosis of a pleural–pulmonary disease in emergency are good, with accuracy >95%. Conclusion About 20% of pneumonia cases were detectable only by CXR and 20% only by TUS and not by CXR; ie, about 40% of patients may have been misdiagnosed if, by chance, only one of the two tools had been used. The concurrent use of TUS and CXR increases the overall sensitivity and

  8. Emerging Technologies: Biosecurity and Consequence Management Implications

    NASA Astrophysics Data System (ADS)

    Perkins, Dana; Nordmann, Brian

    The natural outbreaks of disease and pandemics are transnational threats that create international challenges when detection and containment are not timely due to scarce human and material resources. Whether the cause of those outbreaks is natural or intentional in origin, the main goal of consequence management operations is to save lives. The consequence management process is a continuum of inter-connected phases such as planning, preparation, response, and recovery. The rapid advances of life sciences and the emergence of dual-use technologies such as synthetic biology and nanotechnology pose additional challenges in terms of planning for the unknown potential threats whether they may be synthetic microorganisms with unpredictable dissemination patterns or nanoscale-manipulated biological agents evading current detection capabilities. The US National Strategy for Countering Biological Threats is emphasizing prevention while continuing to support the national preparedness goals and response/recovery capabilities. The recent policies, guidelines, and recommendations on overhauling the biological risk management in the United States are a proactive stance to a rapidly changing global environment. They include optimization of the current oversight frameworks and active engagement of the industry and academia in order to reduce the risk that individuals with ill intent may exploit the commercial application of nucleic acid synthesis technology to access genetic material derived from or by encoding Biological Select Agents or Toxins. We are also actively seeking to increase our knowledge of health effects of various types of nanomaterials, and how to assess, control, and prevent harmful exposure, taking into consideration the numerous gaps that currently exist with regard to the distinct behavior of nanoparticles compared to the same chemical or material at "macro-scale". Fundamentally, a biological incident, whether it is of natural, accidental, or deliberate origin

  9. Trauma unit emergency doctor airway management.

    PubMed

    Hardcastle, T C; Goff, T

    2007-09-01

    To audit indications for and practice (in terms of training/qualification) of definitive airway management compared with current UK practices. Consecutive observational study. Tygerberg Academic Hospital Trauma Service, Western Cape. All trauma patients either arriving intubated or requiring intubation at the Trauma unit during the period 1 - 31 August 2006. A data collection proforma was completed either at the time of intubation or from medical records. Results. Fifty-seven patients required definitive airway management. In the unit 32 patients (56%) were intubated by emergency medicine registrars or medical officers, with rapid sequence intubations (RSIs) in all 32 (100%). Seven patients (12.3%) were intubated by paramedics pre-hospital, and 18 patients (31.6%) were intubated at referring hospitals by non-anaesthetists. Endotracheal intubation was successful in 55 patients (96.4%). Two patients (3.6%) could not be intubated and therefore underwent surgical cricothyroidotomy at the unit. Clinical outcomes included 12 patients (21%) extubated for ward transfer, 7 patients (12.3%) admitted to an intensive care unit (ICU), 21 patients (36.8%) taken for surgery, and 17 patients (29.8%) died. Motor vehicle accident (MVA) was the predominant mechanism of injury, accounting for 30 (52.6%) patients, while 16 patients (28.1%) had penetrating injuries (gunshot and/or stab wounds), 6 patients (10.5%) had blunt trauma, and the remaining 5 patients (8.8%) suffered serious burns. The most common indication for intubation was a Glasgow Coma Score (GCS) of less than 8, typically in the polytrauma patient with suspected head injury due to MVA. Emergency doctors managed 100% of definitive airway in-hospital, and RSI was the favoured method. This differs greatly from the UK where non-anaesthetists only perform between 31% and 56% of trauma intubations, with the rest performed by anaesthetists. Outcome was, however, similar to that described in the literature.

  10. Infectious disease and worldwide declines of amphibian populations, with comments on emerging diseases in coral reef organisms and in humans.

    PubMed Central

    Carey, C

    2000-01-01

    Many populations of amphibians are declining on all six continents on which they occur. Some causes of amphibian declines, such as habitat destruction, direct application of xenobiotics, and introduction of predators or competitors, are clearly attributable to human activities. Infectious disease appears to be the direct cause of mass amphibian die-offs in relatively undisturbed areas of the world where anthropomorphic environmental disruption is minimal. In these cases, it is not yet clear whether these epizootics result from the natural evolution of new pathogens or from environmental changes that promote the emergence of pathogenic forms and/or that weaken the immune defenses of amphibians. Because some aspects of pathogen-related amphibian mass mortalities are similar to outbreaks of new diseases in humans and coral reef organisms, amphibian declines may be part of a much larger pattern than previously appreciated. PMID:10698730

  11. Infectious disease and worldwide declines of amphibian populations, with comments on emerging diseases in coral reef organisms and in humans.

    PubMed

    Carey, C

    2000-03-01

    Many populations of amphibians are declining on all six continents on which they occur. Some causes of amphibian declines, such as habitat destruction, direct application of xenobiotics, and introduction of predators or competitors, are clearly attributable to human activities. Infectious disease appears to be the direct cause of mass amphibian die-offs in relatively undisturbed areas of the world where anthropomorphic environmental disruption is minimal. In these cases, it is not yet clear whether these epizootics result from the natural evolution of new pathogens or from environmental changes that promote the emergence of pathogenic forms and/or that weaken the immune defenses of amphibians. Because some aspects of pathogen-related amphibian mass mortalities are similar to outbreaks of new diseases in humans and coral reef organisms, amphibian declines may be part of a much larger pattern than previously appreciated.

  12. Genetic management of infectious diseases: a heterogeneous epidemio-genetic model illustrated with S. aureus mastitis.

    PubMed

    Detilleux, Johann C

    2005-01-01

    Given that individuals are genetically heterogeneous in their degree of resistance to infection, a model is proposed to formulate appropriate choices that will limit the spread of an infectious disease. The model is illustrated with data on S. aureus mastitis and is based on parameters characterizing the spread of the disease (contact rate, probability of infection after contact, and rate of recovery after infection), the demography (replacement and culling rates) and the genetic composition (degree of relationship and heritability of the disease trait) of the animal population. To decrease infection pressure, it is possible to apply non-genetic procedures that increase the culling (e.g., culling of chronically infected cows) and recovery (e.g., antibiotic therapy) rates of infected cows. But the contribution of the paper is to show that genetic management of infectious disease is also theoretically possible as a control measure complementary to non-genetic actions. Indeed, the probability for an uninfected individual to become infected after contact with an infected one is partially related to their degree of kinship: the more closely they are related, the more likely they are to share identical genes like those associated to the non-resistance to infection. Different prospective genetic management procedures are proposed to decrease the contact rate between infected and uninfected relatives and keep the number of secondary cases generated by one infected animal below 1.

  13. Supporting Community Emergency Management Planning Through a Geocollaboration Software Architecture

    NASA Astrophysics Data System (ADS)

    Schafer, Wendy A.; Ganoe, Craig H.; Carroll, John M.

    Emergency management is more than just events occurring within an emergency situation. It encompasses a variety of persistent activities such as planning, training, assessment, and organizational change. We are studying emergency management planning practices in which geographic communities (towns and regions) prepare to respond efficiently to significant emergency events. Community emergency management planning is an extensive collaboration involving numerous stakeholders throughout the community and both reflecting and challenging the community’s structure and resources. Geocollaboration is one aspect of the effort. Emergency managers, public works directors, first responders, and local transportation managers need to exchange information relating to possible emergency event locations and their surrounding areas. They need to examine geospatial maps together and collaboratively develop emergency plans and procedures. Issues such as emergency vehicle traffic routes and staging areas for command posts, arriving media, and personal first responders’ vehicles must be agreed upon prior to an emergency event to ensure an efficient and effective response. This work presents a software architecture that facilitates the development of geocollaboration solutions. The architecture extends prior geocollaboration research and reuses existing geospatial information models. Emergency management planning is one application domain for the architecture. Geocollaboration tools can be developed that support community-wide emergency management planning and preparedness. This chapter describes how the software architecture can be used for the geospatial, emergency management planning activities of one community.

  14. EMERGING INFECTIOUS DISEASES. Actions Needed to Address the Challenges of Responding to Zika Virus Disease Outbreaks

    DTIC Science & Technology

    2017-05-01

    Center at CDC endangered public health when it failed to disclose that an emergency use authorized CDC test used to detect Zika virus—called the...is sometimes tailored to specific mosquito species .108...HHS officials told us that IVM includes mosquito species surveillance as well as insecticide resistance monitoring in the surveilled species . They

  15. The thermal mismatch hypothesis explains host susceptibility to an emerging infectious disease.

    PubMed

    Cohen, Jeremy M; Venesky, Matthew D; Sauer, Erin L; Civitello, David J; McMahon, Taegan A; Roznik, Elizabeth A; Rohr, Jason R

    2017-02-01

    Parasites typically have broader thermal limits than hosts, so large performance gaps between pathogens and their cold- and warm-adapted hosts should occur at relatively warm and cold temperatures, respectively. We tested this thermal mismatch hypothesis by quantifying the temperature-dependent susceptibility of cold- and warm-adapted amphibian species to the fungal pathogen Batrachochytrium dendrobatidis (Bd) using laboratory experiments and field prevalence estimates from 15 410 individuals in 598 populations. In both the laboratory and field, we found that the greatest susceptibility of cold- and warm-adapted hosts occurred at relatively warm and cool temperatures, respectively, providing support for the thermal mismatch hypothesis. Our results suggest that as climate change shifts hosts away from their optimal temperatures, the probability of increased host susceptibility to infectious disease might increase, but the effect will depend on the host species and the direction of the climate shift. Our findings help explain the tremendous variation in species responses to Bd across climates and spatial, temporal and species-level variation in disease outbreaks associated with extreme weather events that are becoming more common with climate change.

  16. Coincident mass extirpation of neotropical amphibians with the emergence of the infectious fungal pathogen Batrachochytrium dendrobatidis.

    PubMed

    Cheng, Tina L; Rovito, Sean M; Wake, David B; Vredenburg, Vance T

    2011-06-07

    Amphibians highlight the global biodiversity crisis because ∼40% of all amphibian species are currently in decline. Species have disappeared even in protected habitats (e.g., the enigmatic extinction of the golden toad, Bufo periglenes, from Costa Rica). The emergence of a fungal pathogen, Batrachochytrium dendrobatidis (Bd), has been implicated in a number of declines that have occurred in the last decade, but few studies have been able to test retroactively whether Bd emergence was linked to earlier declines and extinctions. We describe a noninvasive PCR sampling technique that detects Bd in formalin-preserved museum specimens. We detected Bd by PCR in 83-90% (n = 38) of samples that were identified as positive by histology. We examined specimens collected before, during, and after major amphibian decline events at established study sites in southern Mexico, Guatemala, and Costa Rica. A pattern of Bd emergence coincident with decline at these localities is revealed-the absence of Bd over multiple years at all localities followed by the concurrent emergence of Bd in various species at each locality during a period of population decline. The geographical and chronological emergence of Bd at these localities also indicates a southbound spread from southern Mexico in the early 1970s to western Guatemala in the 1980s/1990s and to Monteverde, Costa Rica by 1987. We find evidence of a historical "Bd epidemic wave" that began in Mexico and subsequently spread to Central America. We describe a technique that can be used to screen museum specimens from other amphibian decline sites around the world.

  17. Coincident mass extirpation of neotropical amphibians with the emergence of the infectious fungal pathogen Batrachochytrium dendrobatidis

    PubMed Central

    Cheng, Tina L.; Rovito, Sean M.; Wake, David B.; Vredenburg, Vance T.

    2011-01-01

    Amphibians highlight the global biodiversity crisis because ∼40% of all amphibian species are currently in decline. Species have disappeared even in protected habitats (e.g., the enigmatic extinction of the golden toad, Bufo periglenes, from Costa Rica). The emergence of a fungal pathogen, Batrachochytrium dendrobatidis (Bd), has been implicated in a number of declines that have occurred in the last decade, but few studies have been able to test retroactively whether Bd emergence was linked to earlier declines and extinctions. We describe a noninvasive PCR sampling technique that detects Bd in formalin-preserved museum specimens. We detected Bd by PCR in 83–90% (n = 38) of samples that were identified as positive by histology. We examined specimens collected before, during, and after major amphibian decline events at established study sites in southern Mexico, Guatemala, and Costa Rica. A pattern of Bd emergence coincident with decline at these localities is revealed—the absence of Bd over multiple years at all localities followed by the concurrent emergence of Bd in various species at each locality during a period of population decline. The geographical and chronological emergence of Bd at these localities also indicates a southbound spread from southern Mexico in the early 1970s to western Guatemala in the 1980s/1990s and to Monteverde, Costa Rica by 1987. We find evidence of a historical “Bd epidemic wave” that began in Mexico and subsequently spread to Central America. We describe a technique that can be used to screen museum specimens from other amphibian decline sites around the world. PMID:21543713

  18. Managing Emerging Technology: Case Studies in Document Imaging Systems

    DTIC Science & Technology

    1990-01-01

    1990 Thesis/Dissertation 00 S Managing Emerging Technology : Case Studies in Document ( Imaging Systems Richard Kevin Brown AFIT Student at...older report. blank, the abstract is assumed to be unlimited. Standard Form 298 Back (Rev. 2-89) MANAGING EMERGING TECHNOLOGY : CASE STUDIES IN...Brancheau Carroll Fren el Iz e 71 &ur s Date . Brown, Richard Kevin (M.S., Management Science/ Information Systems) Managing Emerging Technology : Case

  19. National treatment practices in the management of infectious intracranial aneurysms and infective endocarditis.

    PubMed

    Singla, Amit; Fargen, Kyle; Blackburn, Spiros; Neal, Dan; Martin, Tomas D; Hess, Phillip J; Beaver, Thomas M; Klodell, Charles T; Hoh, Brian

    2016-07-01

    There is an absence of widely accepted guidelines for the management of infectious intracranial aneurysms (IIAs) owing to a dearth of high-quality evidence in the literature. To better define the incidence of IIAs, treatment practices, and patient outcomes by performing a Nationwide Inpatient Sample (NIS) database query. We queried the NIS database from 2002 to 2011 for all patients with the primary diagnosis of infectious endocarditis (IE), subarachnoid hemorrhage (SAH), or unruptured cerebral aneurysm by ICD-9-CM codes. ICD-9 procedure codes were used to identify patients undergoing neurosurgical or cardiothoracic procedures. The query identified 393 patients with primary diagnosis of IE, SAH or unruptured cerebral aneurysm treated during 2002-2011. The mean age of the patients was 53.5 years; 244 (62%) were male. The majority of patients presented with SAH (361; 91.9%). Only 73 (18.6%) patients underwent neurosurgical coiling or clipping for IIA. Of patients undergoing a neurosurgical procedure, 65 had SAH (constituting only 18% of patients with SAH) and 8 had unruptured aneurysms (constituting only 25% patients with unruptured aneurysms). Cardiac procedures were performed in only 72/393 patients (18.3%) patients. Only 67 (18.6%) of the patients with SAH and 5 (15.6%) with unruptured aneurysms underwent a cardiac corrective surgical procedure. Mortality was significantly higher in those patients managed conservatively (26.7%) than in those who underwent clipping or embolization (15.1%; p<0.001). In this NIS database study, the majority of patients with IIAs were managed non-operatively, regardless of rupture status. Further investigation is warranted to standardize the management of these lesions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Tourism and Emerging and Re-emerging Infectious Diseases in the Americas: What Physicians Must Remember for Patient Diagnosis and Care.

    PubMed

    Schmunis; Corber

    1999-04-01

    Emerging diseases are those which have shown an increased in humans over the last 20 years. Re-emerging diseases are those which have reappeared after a period of significant decrease in incidence. The etiological agents of these diseases in the Western Hemisphere are viruses (HIV, dengue, oroupuche, sabia, guanarito, or hanta), bacteria (Vibrio cholera, Borrellia burgdorferi, Legionella pneumofila, Eseherichia coli 0157:H7, or other bacteria with a new pattern of antibiotic resistance), or parasites (Cryptosporidia, Cyclosporidia or drug resistant Plasmodium falciparum). Due to the widespread geographical distribution of these infectious diseases in the Americas, and an increasing number of travellers (more than 87 million persons within the region in 1997), there are many opportunities to contract an infection when travelling in developed or undeveloped countries. The infection may present with symptoms during the trip, or following the traveler s return to his or her place of origin. However, too often practicing physicians do not inquire about the travel history of their patients and, when they do, they often lack the information about diseases relevant to travelers. From the regional perspective, the emerging or reemerging agents that pose a higher risk to tourists or travelers are: 1) those that cause enteric infections; 2) sexually transmitted diseases; and 3) vector-borne diseases, including those present in ecotourism areas. Emerging and re-emerging diseases that physicians may encounter in their clinical practice while caring for travelers returning from different countries of the Western Hemisphere are briefly described (Lyme disease, legionellosis, dengue, yellow fever, P. falciparum malaria, cyclosporidiosis and cryptosporidiosis). This report attempts to draw attention to the fact that new clinical and etiological entities are present in several geographical areas of the Americas; to place each of these entities into an epidemiological context; and to

  1. Addressing Emerging Infectious Disease Threats A Strategic Plan for the Department of Defense

    DTIC Science & Technology

    1998-01-01

    in occurrence of antibiotic resistance that outpaces the some ways significantly less prepared than many development of new drugs ; changes in sexual...epidemics. lance of indigenous and expatriate popu- lations for drug -resistant enteric organ- DoD Emerging Infections isms, drug -resistant malaria...medical research unit serve as a model for of drugs and biologics, and the initiation regional surveillance efforts and thus of large-scale

  2. Septic vasculitis and vasculopathy in some infectious emergencies: the perspective of the histopathologist.

    PubMed

    Tomasini, C

    2015-02-01

    Sepsis is a potentially life-threatening complication of an infection where cutaneous lesions often represent one of the early signs. A myriad of microorganisms including bacteria, fungi, yeasts, viruses, protozoas, helminths and algae can be implicated. A broad spectrum of clinical and histopathologic findings can be observed in the skin and the common denominator is a thrombotic vasculopathy. The pathogenesis of cutaneous septic vasculitis (SV)/vasculopathy is complex and includes five main mechanisms: disseminated intravascular coagulation, direct invasion and occlusion of blood vessel walls by microorganisms, hypersensitivity reaction with immune complex deposition into blood vessel walls, embolism from a distant infectious site and vascular effects of toxins. Herein we describe the clinicopathologic findings of some selected cases of SV recently observed in our hospital, including purpura fulminans, necrotizing fasciitis, cutaneous meningococcemia, malignant syphilis and disseminated alternaria infection. Histopathologically, a wide spectrum of histopathologic changes was observed in skin specimens from the various entities, involving the intensity and composition of the inflammatory infiltrate, the degree of vascular changes and the presence of microorganisms, that ranged from a predominant not inflammatory, thrombotic-occlusive vasculopathy in purpura fulminans to leukocytoclastic vasculitis like changes in cutaneous meningococcemia to a dermal angiomatosis-like pattern in disseminated Alternaria infection. The different pathologic presentations may be related to the microorganism involved, the main pathogenetic mechanism that induced the vascular injury and the individual immunologic burden. Early skin biopsy for histopathologic examination and microbiologic culture is a cornerstone in the diagnosis of life-threatening diseases that present with cutaneous septic vasculitis. Ancillary techniques, such as immunohistochemistry and polymerase chain reaction are

  3. Rosacea: update on management and emerging therapies.

    PubMed

    Fallen, Robyn S; Gooderham, Melinda

    2012-12-01

    Rosacea is a common chronic skin disorder that has significant impact on the self-esteem and quality of life of affected individuals. Currently understood as an inflammatory condition that occurs in the context of an altered innate immune response, the available topical and systemic therapies function as immunomodulators to restore cutaneous homeostasis. The goals of therapy include reduction of papules, pustules, erythema and physical discomfort with improvement in quality of life. Standard topical treatments include metronidazole and azelaic acid, although many other agents and regimens have been presented. Subantimicrobial/antiinflammatory dose oral doxycycline was US FDA approved in 2006 for the management of rosacea, but Health Canada clearance was only recently granted for this indication. Furthermore, renewed research interest has led to the development of other emerging therapies including topical ivermectin, brimonidine and oxymetazoline that hold promise for patients suffering from this condition.

  4. The Use of Expert Opinion to Assess the Risk of Emergence or Re-Emergence of Infectious Diseases in Canada Associated with Climate Change

    PubMed Central

    Cox, Ruth; Revie, Crawford W.; Sanchez, Javier

    2012-01-01

    Global climate change is predicted to lead to an increase in infectious disease outbreaks. Reliable surveillance for diseases that are most likely to emerge is required, and given limited resources, policy decision makers need rational methods with which to prioritise pathogen threats. Here expert opinion was collected to determine what criteria could be used to prioritise diseases according to the likelihood of emergence in response to climate change and according to their impact. We identified a total of 40 criteria that might be used for this purpose in the Canadian context. The opinion of 64 experts from academic, government and independent backgrounds was collected to determine the importance of the criteria. A weight was calculated for each criterion based on the expert opinion. The five that were considered most influential on disease emergence or impact were: potential economic impact, severity of disease in the general human population, human case fatality rate, the type of climate that the pathogen can tolerate and the current climatic conditions in Canada. There was effective consensus about the influence of some criteria among participants, while for others there was considerable variation. The specific climate criteria that were most likely to influence disease emergence were: an annual increase in temperature, an increase in summer temperature, an increase in summer precipitation and to a lesser extent an increase in winter temperature. These climate variables were considered to be most influential on vector-borne diseases and on food and water-borne diseases. Opinion about the influence of climate on air-borne diseases and diseases spread by direct/indirect contact were more variable. The impact of emerging diseases on the human population was deemed more important than the impact on animal populations. PMID:22848536

  5. Role of the Infectious Disease Consultant in Management of Patients With Tuberculosis-Associated Ocular Inflammation

    PubMed Central

    Conant, Marjorie M.; Vrasich, Chuck R.; Wongskhaluang, Jeff V.; Ferenchak, Kevin; Asano, Matthew K.; Becker, Norbert; DeMarais, Patricia

    2016-01-01

    Background. Tuberculosis is a disease with continued worldwide prevalence, morbidity, and mortality. Tuberculosis-associated ocular inflammation (TB-AOI) is a manifestation that can occur with pulmonary or extrapulmonary TB. Evaluation of these ocular presentations and treatment in the United States are limited. Our objective was to describe cases in an urban area and assess the role of the infectious diseases specialist in managing these complex patients. Methods. We performed a retrospective case series of all patients referred to our infectious disease clinic for presumed TB-AOI from 2005 through 2013. Patients with ocular inflammation were determined to have presumed TB-AOI based on clinical presentation with correlative positive tuberculin skin test and/or QuantiFERON-TB Gold. Attempts were made to exclude other diagnoses. Data were collected and analyzed with respect to demographics, ocular manifestations, and treatment. Results. Sixty eyes of 42 patients were included in the study; anterior uveitis was the most common site of involvement. The median age was 46 years, and 33 patients (79%) were foreign born. Forty patients (95%) received a course of antituberculous therapy with 38% experiencing treatment-related side effects. A 6-month duration was recommended in 78% cases. There was improvement or stability of the vision in 42 eyes (74%) of those treated. Conclusions. Ocular involvement is an uncommon but important manifestation of TB. Our data further characterize TB-AOI cases in the United States. Treatment provides significant benefit to properly selected patients. A multidisciplinary approach, with care provided by ophthalmology and infectious disease providers, should be used to allow for the most efficacious treatment. PMID:26811844

  6. Innovative dairy cow management to improve resistance to metabolic and infectious diseases during the transition period.

    PubMed

    Lacasse, P; Vanacker, N; Ollier, S; Ster, C

    2017-06-27

    The incidence of metabolic and infectious diseases varies greatly during the lactation cycle. Most new cases of clinical mastitis appear at the beginning of lactation, and the incidence increases with the level of milk production. In addition to mastitis, many other infectious diseases become clinically apparent during the first 2weeks of lactation. During this time, cows are in a negative energy balance and must mobilize body reserves to balance the deficit between food energy intake and energy required for milk production. The relationships between energy deficit and metabolic diseases, such as ketosis and hepatic lipidosis, are well known. Furthermore, cows in energy deficit have a weakened immune system and are therefore more susceptible to infections. There is now good evidence that the increase in circulating non-esterified fatty acids impairs immune cell functions. Therefore, management approaches that reduce the negative energy balance and the increase in non-esterified fatty acids at the beginning of lactation are likely to improve resistance to infection. Improving the nutrient supply through periparturient nutritional management has been the subject of considerable research. However, another way to reduce the imbalance between nutrient supply and demand is to temporarily decrease the latter. In this review, we examine how management strategies such as conjugated linoleic acid feeding, prepartum milking, or limiting postpartum milk production could be used to reduce metabolic perturbations and immunosuppression during the transition period. At this stage, it appears that reducing the amount of milk harvested postpartum by means of partial milking in the first days after calving is the most promising approach to reduce metabolic stress and immunosuppression without compromising the productivity of high-yielding dairy cows. Copyright © 2017. Published by Elsevier Ltd.

  7. Emergency management training program: Guide to good practice

    SciTech Connect

    Not Available

    1991-07-01

    The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate components of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager`s point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.

  8. Intrahepatic cholangiocarcinoma: current management and emerging therapies.

    PubMed

    Rahnemai-Azar, Amir A; Weisbrod, Allison B; Dillhoff, Mary; Schmidt, Carl; Pawlik, Timothy M

    2017-05-01

    Intrahepatic cholangiocarcinoma (iCCA) is a malignancy with an increasing incidence and a high-case fatality. While surgery offers the best hope at long-term survival, only one-third of tumors are amenable to surgical resection at the time of the diagnosis. Unfortunately, conventional chemotherapy offers limited survival benefit in the management of unresectable or metastatic disease. Recent advances in understanding the molecular pathogenesis of iCCA and the use of next-generation sequencing techniques have provided a chance to identify 'target-able' molecular aberrations. These novel molecular therapies offer the promise to personalize therapy for patients with iCCA and, in turn, improve the outcomes of patients. Area covered: We herein review the current management options for iCCA with a focus on defining both established and emerging therapies. Expert commentary: Surgical resection remains as an only hope for cure in iCCA patients. However, frequently the diagnosis is delayed till advanced stages when surgery cannot be offered; signifying the urge for specific diagnostic tumor biomarkers and targeted therapies. New advances in genomic profiling have contributed to a better understanding of the landscape of molecular alterations in iCCA and offer hope for the development of novel diagnostic biomarkers and targeted therapies.

  9. Barrett's Esophagus: Emerging Knowledge and Management Strategies

    PubMed Central

    Bhardwaj, Atul; Stairs, Douglas B.; Mani, Haresh; McGarrity, Thomas J.

    2012-01-01

    The incidence of esophageal adenocarcinoma (EAC) has increased exponentially in the last 3 decades. Barrett's esophagus (BE) is the only known precursor of EAC. Patients with BE have a greater than 40 folds higher risk of EAC compared with the general population. Recent years have witnessed a revolution in the clinical and molecular research related to BE. However, several aspects of this condition remain controversial. Data regarding the true prevalence of BE have varied widely. Recent studies have suggested a lower incidence of EAC in nondysplastic BE (NDBE) than previously reported. There is paucity of prospective data showing a survival benefit of screening or surveillance for BE. Furthermore, the ever-increasing emphasis on healthcare cost containment has called for reexamination of the screening and surveillance strategies for BE. There is a need for identification of reliable clinical predictors or molecular biomarkers to risk-stratify patients who might benefit the most from screening or surveillance for BE. Finally, new therapies have emerged for the management of dysplastic BE. In this paper, we highlight the key areas of controversy and uncertainty surrounding BE. The paper discusses, in detail, the current literature about the molecular pathogenesis, biomarkers, histopathological diagnosis, and management strategies for BE. PMID:22701199

  10. Emergence of Avian Infectious Bronchitis Virus and its variants need better diagnosis, prevention and control strategies: a global perspective.

    PubMed

    Dhama, Kuldeep; Singh, Shambhu Dayal; Barathidasan, Rajamani; Desingu, P A; Chakraborty, Sandip; Tiwari, Ruchi; Kumar, M Asok

    2014-06-01

    Growth in poultry sector is being challenged due to increased incidence and re-emergence of diseases caused due to evolution of several viral pathogens and use of live vaccines. Piles of economic losses are encountered due to these diseases. Avian Infectious Bronchitis (IB), caused by Corona virus, is OIE-listed disease and characterized by respiratory, renal and urogenital involvements, causing high mortality. Economic losses are encountered due to loss of productive performance of both egg and meat-type chickens. Variant viruses evolve due to spontaneous mutations and recombinations, causing disease in vaccinated flocks of all ages. Serotyping and genotyping are the common methods of classification of IBV strains. The virus has 4 clusters, grouped into 7 serotypes and the most important strains are Massachusetts, Connecticut, Arkansas, Gray, Holte and Florida along with numerous others, distributed round the globe. Several conventional and molecular diagnostic methods have been described for the diagnosis of IB in chickens. 'All-in/all-out' operations of rearing along with good biosafety measures forms the basis of prevention, whereas vaccination forms the backbone of IB control programme. Both live and inactivated (oil emulsified) conventional vaccines are available. The new generation vaccines (recombinant and vector-based) developed against locally prevailing IBV strains may be more helpful and avoid the reversion of virulence in live vaccine viruses. The present review deals with all these perspectives of this important emerging poultry pathogen.

  11. Will the damage be done before we feel the heat? Infectious disease emergence and human response.

    PubMed

    Kock, R A

    2013-12-01

    The global political economy is facing extreme challenges against a backdrop of large-scale expansion of human and domestic animal populations and related impacts on the biosphere. Significant global socio-ecological changes have occurred in the period of a single lifetime, driven by increased technology and access to physical and biological resources through open markets and globalization. Current resource consumption rates are not sustainable and ecological tipping points are being reached and one of the indicators of these may be a changing balance between hosts and pathogens. A period of extraordinary progress in reducing infection risk and disease impact on humans and domestic animals in the 20th Century is reversing in the 21st, but not always and not everywhere. Drivers for this shift are discussed in terms of demographics, agroecology, biodiversity decline and loss of resilience in ecosystems, climate change and increasing interconnectedness between species globally. Causality of disease emergence remains highly speculative, but patterns and data are emerging to commend a precautionary approach, while reassessing our global political, social and economic systems.

  12. Pteropine orthoreovirus: An important emerging virus causing infectious disease in the tropics?

    PubMed

    Tan, Yeh Fong; Teng, Cheong Lieng; Chua, Kaw Bing; Voon, Kenny

    2017-03-31

    Pteropine orthoreovirus (PRV) is an emerging zoonotic respiratory virus that has spilled over from bats to humans. Though initially found only in bats, further case studies have found viable virus in ill patients. PubMed was queried with the keywords of Nelson Bay orthoreovirus OR Pteropine orthoreovirus OR Melaka orthoreovirus OR Kampar orthoreovirus, and returned 17 hits. Based on prevalence studies, the presence of PRV has been reported in Malaysia and Vietnam, both developing countries. Other case reports also provide further evidence of the presence of PRV in the Southeast Asian region. Despite the absence of PRV in their home countries, travellers from Hong Kong and Japan to Indonesia have returned to their countries ill with this virus, indicating that local communities in Indonesia might be affected by this virus. This work aims to bring to light this emerging zoonotic respiratory virus circulating among developing countries in Southeast Asia. To improve the understanding of PRV of the medical and scientific community in the Southeast Asian region, this work introduces the general features of PRV, reports of imported PRV, prevalence, and clinical features of PRV. Gaps in knowledge about PRV have also been identified in this work, and we hope that future studies can be undertaken to improve our understanding of this virus.

  13. Group A Streptococcus: a re-emergent pathogen. Infectious Diseases and Immunization Committee, Canadian Paediatric Society.

    PubMed Central

    1993-01-01

    Rheumatic fever is still rare in North America but must continue to be considered in the appropriate clinical setting. Invasive or severe GABHS disease remains unusual and is unlikely to be missed by the practitioner; however, it is essential that GABHS infection be considered as a possible cause of a severe sepsis-like syndrome. Currently the routine management of GABHS infection is unchanged; however, heightened awareness of the infection's rare, more serious complications is needed. PMID:8500028

  14. Virulence variation among strains of the emerging infectious fungus Batrachochytrium dendrobatidis (Bd) in multiple amphibian host species.

    PubMed

    Dang, Trang D; Searle, Catherine L; Blaustein, Andrew R

    2017-05-11

    Emerging infectious diseases have been documented in numerous plant and animal populations. The infectious disease amphibian chytridiomycosis, caused by the fungus Batrachochytrium dendrobatidis (Bd), is associated with global amphibian population declines. While much Bd-amphibian research has centered on response variation in hosts, a paucity of information exists on how variation in the pathogen, such as strain differences, affects infection dynamics. To examine how different Bd strains may differentially impact multiple hosts, we conducted laboratory experiments to measure 2 infection outcomes, viz. host survival and pathogen load, in 3 amphibian host species (Pacific treefrog, western toad, and Cascades frog) after exposure to 3 different Bd strains (an additional fourth Bd strain was tested in toads only). Our results confirm that the infection response differs among host species. Western toads experienced significant mortality, but Pacific treefrogs and Cascades frogs did not. Interestingly, our experiment also captured strain-dependent virulence variation but only in 1 host species, the western toad. Increased mortality was observed in 2 of the 4 Bd strains tested in this host species. Toads were also the only host species found to have variable pathogen load dependent on strain type; individuals exposed to the Panama strain harbored significantly higher loads compared to all other strains. These findings underscore the dynamic nature of Bd infection, showing that virulence can vary contingent on host and strain type. We highlight the importance of both host- and pathogen-dependent factors in determining overall infection virulence and show the need for in vivo testing to fully assess pathogenicity.

  15. Emergency management training program: Guide to good practice

    SciTech Connect

    Not Available

    1991-07-01

    The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate components of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager's point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.

  16. Prevention and control of emergent infectious disease with high specific antigen sensor.

    PubMed

    Zhang, Hongzhe; Zhang, Shanshan; Liu, Nan

    2017-05-18

    This study aims to evaluate the application of a new type of high specificity antigen sensor in detecting the viruses in sudden infectious diseases. Influenza A (H1N1) virus immunosensor was used for the respective determination of the six kinds of antigens of H1N1, H3N2 viral protein, HA protein of H7N9, influenza B virus, adenovirus, and EV71 virus of same dilution degree on the Screen Printed Carbon Electrode (SPCE), so as to test the specificity of the detection method. In addition, various batches of chick embryo allantoic saliva dilution simulation samples were also detected on their recovery (accuracy), repeatability (precision), and stability. The results were as follows: the linear equation was y = 121.33x + 168; the slope of the linear equation was 121.33 nA/HA unit, representing the sensitivity; correlation coefficient was R(2)=0.9921 > 0.90. Using Statistical Analysis System (SAS) software, we found that: the W values of seven sets of data after Shapiro-Wilk detection were 0.853, 0.991, 0.901, 0.906, 0.825, 0.974, and 0.992, respectively; P values were 0.247, 0.831, 0.386, 0.405, 0.174, 0.691, and 0.821, respectively, all of which were greater than 0.05, suggesting that normality was met. The results of homogeneity test for variance were as follows: F = 2.44, P = 0.0775 > 0.05, suggesting that homogeneity of variance was met. The parametric test results were as follows: F = 19114.0, P < 0.0001, suggesting that there were obvious differences between testing data of the seven groups. The determination recovery rate of electrochemical immunosensor was 80-110%. Relative Standard Deviation (RSD) values of repeatability (precision) test of H1N1 influenza virus electrochemical immunosensor were 7.74%, 3.54%, and 2.01%, all of which were smaller than 10%. The signal response of H1N1 electrochemical immune biological sensor could still maintain more than 85% of the original signal within 30 days of storage. In conclusion, H1N1

  17. Myxomatosis in Australia and Europe: a model for emerging infectious diseases.

    PubMed

    Kerr, Peter J

    2012-03-01

    Myxoma virus is a poxvirus naturally found in two American leporid (rabbit) species (Sylvilagus brasiliensis and Sylvilagus bachmani) in which it causes an innocuous localised cutaneous fibroma. However, in European rabbits (Oryctolagus cuniculus) the same virus causes the lethal disseminated disease myxomatosis. The introduction of myxoma virus into the European rabbit population in Australia in 1950 initiated the best known example of what happens when a novel pathogen jumps into a completely naïve new mammalian host species. The short generation time of the rabbit and their vast numbers in Australia meant evolution could be studied in real time. The carefully documented emergence of attenuated strains of virus that were more effectively transmitted by the mosquito vector and the subsequent selection of rabbits with genetic resistance to myxomatosis is the paradigm for pathogen virulence and host-pathogen coevolution. This natural experiment was repeated with the release of a separate strain of myxoma virus in France in 1952. The subsequent spread of the virus throughout Europe and its coevolution with the rabbit essentially paralleled what occurred in Australia. Detailed molecular studies on myxoma virus have dissected the role of virulence genes in the pathogenesis of myxomatosis and when combined with genomic data and reverse genetics should in future enable the understanding of the molecular evolution of the virus as it adapted to its new host. This review describes the natural history and evolution of myxoma virus together with the molecular biology and experimental pathogenesis studies that are informing our understanding of evolution of emerging diseases. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

  18. Fungal necrotizing fasciitis, an emerging infectious disease caused by Apophysomyces (Mucorales).

    PubMed

    Chander, Jagdish; Stchigel, Alberto Miguel; Alastruey-Izquierdo, Ana; Jayant, Mayank; Bala, Kiran; Rani, Hena; Handa, Uma; Punia, Rajpal Singh; Dalal, Usha; Attri, Ashok Kumar; Monzon, Araceli; Cano-Lira, José Francisco; Guarro, Josep

    2015-01-01

    The mucoralean fungi are emerging causative agents of primary cutaneous infections presenting in the form of necrotizing fasciitis. The aim of this study was to investigate a series of suspected necrotizing fasciitis cases by Apophysomyces species over one-year period in a northern Indian hospital. The clinical details of those patients suspected to suffer from fungal necrotizing fasciitis were recorded. Skin biopsies from local wounds were microscopically examined and fungal culturing was carried out on standard media. The histopathology was evaluated using conventional methods and special stains. Apophysomyces isolates were identified by their morphology and by molecular sequencing of the internal transcribed spacer (ITS) region of the ribosomal genes. Antifungal susceptibility testing was carried out following EUCAST guidelines and treatment progress was monitored. Seven patients were found to be suffering from necrotizing fasciitis caused by Apophysomyces spp. Six isolates were identified as Apophysomyces variabilis and one as Apophysomyces elegans. Five patients had previously received intramuscular injections in the affected area. Three patients recovered, two died and the other two left treatment against medical advice and are presumed to have died due to their terminal illnesses. Posaconazole and terbinafine were found to be the most active compounds against A. variabilis, while the isolate of A. elegans was resistant to all antifungals tested. Apophysomyces is confirmed as an aggressive fungus able to cause fatal infections. All clinicians, microbiologists and pathologists need to be aware of these emerging mycoses as well as of the risks involved in medical practices, which may provoke serious fungal infections such as those produced by Apophysomyces. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  19. How next-generation sequencing and multiscale data analysis will transform infectious disease management.

    PubMed

    Pak, Theodore R; Kasarskis, Andrew

    2015-12-01

    Recent reviews have examined the extent to which routine next-generation sequencing (NGS) on clinical specimens will improve the capabilities of clinical microbiology laboratories in the short term, but do not explore integrating NGS with clinical data from electronic medical records (EMRs), immune profiling data, and other rich datasets to create multiscale predictive models. This review introduces a range of "omics" and patient data sources relevant to managing infections and proposes 3 potentially disruptive applications for these data in the clinical workflow. The combined threats of healthcare-associated infections and multidrug-resistant organisms may be addressed by multiscale analysis of NGS and EMR data that is ideally updated and refined over time within each healthcare organization. Such data and analysis should form the cornerstone of future learning health systems for infectious disease.

  20. How Next-Generation Sequencing and Multiscale Data Analysis Will Transform Infectious Disease Management

    PubMed Central

    Pak, Theodore R.; Kasarskis, Andrew

    2015-01-01

    Recent reviews have examined the extent to which routine next-generation sequencing (NGS) on clinical specimens will improve the capabilities of clinical microbiology laboratories in the short term, but do not explore integrating NGS with clinical data from electronic medical records (EMRs), immune profiling data, and other rich datasets to create multiscale predictive models. This review introduces a range of “omics” and patient data sources relevant to managing infections and proposes 3 potentially disruptive applications for these data in the clinical workflow. The combined threats of healthcare-associated infections and multidrug-resistant organisms may be addressed by multiscale analysis of NGS and EMR data that is ideally updated and refined over time within each healthcare organization. Such data and analysis should form the cornerstone of future learning health systems for infectious disease. PMID:26251049

  1. Promising New Assays and Technologies for the Diagnosis and Management of Infectious Diseases

    PubMed Central

    Mitsuma, S. F.; Mansour, M. K.; Dekker, J. P.; Kim, J.; Rahman, M. Z.; Tweed-Kent, A.; Schuetz, P.

    2013-01-01

    In the first decade of the 21st century, we have seen the completion of the human genome project and marked progress in the human microbiome project. The vast amount of data generated from these efforts combined with advances in molecular and biomedical technologies have led to the development of a multitude of assays and technologies that may be useful in the diagnosis and management of infectious diseases. Here, we identify several new assays and technologies that have recently come into clinical use or have potential for clinical use in the near future. The scope of this review is broad and includes topics such as the serum marker procalcitonin, gene expression profiling, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and nucleic acid aptamers. Principles that underlie each assay or technology, their clinical applications, and potential strengths and limitations are addressed. PMID:23223587

  2. Los Alamos National Laboratory emergency management plan. Revision 1

    SciTech Connect

    Ramsey, G.F.

    1998-07-15

    The Laboratory has developed this Emergency Management Plan (EMP) to assist in emergency planning, preparedness, and response to anticipated and actual emergencies. The Plan establishes guidance for ensuring safe Laboratory operation, protection of the environment, and safeguarding Department of Energy (DOE) property. Detailed information and specific instructions required by emergency response personnel to implement the EMP are contained in the Emergency Management Plan Implementing Procedure (EMPIP) document, which consists of individual EMPIPs. The EMP and EMPIPs may be used to assist in resolving emergencies including but not limited to fires, high-energy accidents, hazardous material releases (radioactive and nonradioactive), security incidents, transportation accidents, electrical accidents, and natural disasters.

  3. Emerging information management technologies and the future of disease management.

    PubMed

    Nobel, Jeremy J; Norman, Gordon K

    2003-01-01

    Disease management (DM) has become a widely accepted way to support care delivery in the chronically ill patient population. Patients enrolled in these programs have been shown to have better health, fewer complications and comorbidities, and lower health care costs. The development of advanced information management technologies is further enhancing the role DM plays in optimizing outcomes and cost-effectiveness in clinical care. These emerging information management technologies (EIMT) include advances in software, hardware, and networking, all of which share common impact attributes in their ability to improve cost-effectiveness of care, quality of care, and access to care. Specific examples include interactive websites with the ability to engage patients in the self-care management process, the embedding of biometric devices (digital scales, modem-enabled glucose meters in the home, blood pressure monitoring, etc.), workflow and care coordination programs that add intelligence via guideline-directed alerts and reminders to the delivery process, registries that include a summary of personal health data that can be used as a reference point for improved clinical decisions, and the systematic collection of aggregated, de-identified clinical, administrative, and cost data into comprehensive data sets to which predictive modeling analytic tools can be applied. By way of case example, we also present data from a controlled clinical trial utilizing EIMT in the form of home-based weight measurement using a digital scale and linkage to a care coordination center for the management of severe congestive heart failure. Outcome results on 85,515 patient-months of an aggregate commercial and Medicare continuously enrolled population demonstrated an average reduction of care utilization (hospitalization) of 57% and a reduction in related delivery cost (per member per year payments) of 55%. We conclude that EIMT have already begun to offer significant and quantifiable benefits

  4. The Public Sphere in Emerging Infectious Disease Communication: Recipient or Active and Vocal Partner?

    PubMed

    Gesser-Edelsburg, Anat; Shir-Raz, Yaffa; Walter, Nathan; Mordini, Emilio; Dimitriou, Dimitris; James, James J; Green, Manfred S

    2015-08-01

    Recent years have seen advances in theories and models of risk and crisis communication, with a focus on emerging epidemic infection. Nevertheless, information flow remains unilateral in many countries and does not take into account the public's polyvocality and the fact that its opinions and knowledge often "compete" with those of health authorities. This article addresses the challenges organizations face in communicating with the public sphere. Our theoretical approach is conceptualized through a framework that focuses on the public sphere and that builds upon existing guidelines and studies in the context of health and pandemics. We examine how health organizations cope with the public's transformation from recipients to an active and vocal entity, ie, how and to what extent health organizations address the public's anxiety and concerns arising in the social media during outbreaks. Although international organizations have aspired to relate to the public as a partner, this article identifies notable gaps. Organizations must involve the public throughout the crisis and conduct dialogues free of prejudices, paternalism, and preconceptions. Thereby, they can impart precise and updated information reflecting uncertainty and considering cultural differences to build trust and facilitate cooperation with the public sphere.

  5. Evolution in action: climate change, biodiversity dynamics and emerging infectious disease.

    PubMed

    Hoberg, Eric P; Brooks, Daniel R

    2015-04-05

    Climatological variation and ecological perturbation have been pervasive drivers of faunal assembly, structure and diversification for parasites and pathogens through recurrent events of geographical and host colonization at varying spatial and temporal scales of Earth history. Episodic shifts in climate and environmental settings, in conjunction with ecological mechanisms and host switching, are often critical determinants of parasite diversification, a view counter to more than a century of coevolutionary thinking about the nature of complex host-parasite assemblages. Parasites are resource specialists with restricted host ranges, yet shifts onto relatively unrelated hosts are common during phylogenetic diversification of parasite lineages and directly observable in real time. The emerging Stockholm Paradigm resolves this paradox: Ecological Fitting (EF)--phenotypic flexibility and phylogenetic conservatism in traits related to resource use, most notably host preference--provides many opportunities for rapid host switching in changing environments, without the evolution of novel host-utilization capabilities. Host shifts via EF fuel the expansion phase of the Oscillation Hypothesis of host range and speciation and, more generally, the generation of novel combinations of interacting species within the Geographic Mosaic Theory of Coevolution. In synergy, an environmental dynamic of Taxon Pulses establishes an episodic context for host and geographical colonization.

  6. Evolution in action: climate change, biodiversity dynamics and emerging infectious disease

    PubMed Central

    Hoberg, Eric P.; Brooks, Daniel R.

    2015-01-01

    Climatological variation and ecological perturbation have been pervasive drivers of faunal assembly, structure and diversification for parasites and pathogens through recurrent events of geographical and host colonization at varying spatial and temporal scales of Earth history. Episodic shifts in climate and environmental settings, in conjunction with ecological mechanisms and host switching, are often critical determinants of parasite diversification, a view counter to more than a century of coevolutionary thinking about the nature of complex host–parasite assemblages. Parasites are resource specialists with restricted host ranges, yet shifts onto relatively unrelated hosts are common during phylogenetic diversification of parasite lineages and directly observable in real time. The emerging Stockholm Paradigm resolves this paradox: Ecological Fitting (EF)—phenotypic flexibility and phylogenetic conservatism in traits related to resource use, most notably host preference—provides many opportunities for rapid host switching in changing environments, without the evolution of novel host-utilization capabilities. Host shifts via EF fuel the expansion phase of the Oscillation Hypothesis of host range and speciation and, more generally, the generation of novel combinations of interacting species within the Geographic Mosaic Theory of Coevolution. In synergy, an environmental dynamic of Taxon Pulses establishes an episodic context for host and geographical colonization. PMID:25688014

  7. Emergency medicine in pediatric dentistry: preparation and management.

    PubMed

    Malamed, Stanley F

    2003-10-01

    Medical emergencies can and do occur in the practice of dentistry. Although most emergencies take place in adults, serious problems can also develop in younger patients. The contemporary dentist must be prepared to manage expeditiously and effectively those few problems that do arise. Basic life support (as necessary) is all that is required to manage many emergency situations, with the addition of specific drug therapy in some others. Preparation of the office and staff includes basic life support (annually), pediatric advanced life support, development of an emergency team, consideration for emergency medical services, and the availability of emergency drugs and equipment with the ability to use these items effectively. As with the adult patient, effective management of pain (local anesthesia) and anxiety (behavioral management, conscious sedation) will minimize the development of medical emergencies.

  8. International Health Regulations, Ebola, and Emerging Infectious Diseases in Latin America and the Caribbean

    PubMed Central

    Aldighieri, Sylvain; John, Ronald St.; Becerra-Posada, Francisco; Etienne, Carissa

    2016-01-01

    The World Health Organization’s determination of the Ebola virus disease outbreak as a public health event of international concern prompted nonaffected countries to implement measures to prevent, detect, and manage the introduction of the virus in their territories. The outbreak provided an opportunity to assess the operational implementation of the International Health Regulations’ core capacities and health systems’ preparedness to handle a potential or confirmed case of Ebola virus disease. A public health framework implemented in Latin America and Caribbean countries encompassing preparatory self-assessments, in-country visits, and follow-up suggests that the region should increase efforts to consolidate and sustain progress on core capacities and health system preparedness to face public health events with national or international repercussions. PMID:26691130

  9. Auditing emergency management programmes: Measuring leading indicators of programme performance.

    PubMed

    Tomsic, Heather

    Emergency Management Programmes benefit from review and measurement against established criteria. By measuring current vs required programme elements for their actual currency, completeness and effectiveness, the resulting timely reports of achievements and documentation of identified gaps can effectively be used to rationally support prioritised improvement. Audits, with their detailed, triangulated and objectively weighted processes, are the ultimate approach in terms of programme content measurement. Although Emergency Management is often presented as a wholly separate operational mechanism, distinct and functionally different from the organisation's usual management structure, this characterisation is only completely accurate while managing an emergency itself. Otherwise, an organisation's Emergency Management Programme is embedded within that organisation and dependent upon it. Therefore, the organisation's culture and structure of management, accountability and measurement must be engaged for the programme to exist, much less improve. A wise and successful Emergency Management Coordinator does not let the separate and distinct nature of managing an emergency obscure their realisation of the need for an organisation to understand and manage all of the other programme components as part of its regular business practices. This includes its measurement. Not all organisations are sufficiently large or capable of supporting the use of an audit. This paper proposes that alternate, less formal, yet effective mechanisms can be explored, as long as they reflect and support organisational management norms, including a process of relatively informal measurement focused on the organisation's own perception of key Emergency Management Programme performance indicators.

  10. The Evolution of Public Health Emergency Management as a Field of Practice

    PubMed Central

    Murthy, Shivani; Brooks, Jennifer; Bryant, Jeffrey

    2017-01-01

    The health impacts of recent global infectious disease outbreaks and other disasters have demonstrated the importance of strengthening public health systems to better protect communities from naturally occurring and human-caused threats. Public health emergency management (PHEM) is an emergent field of practice that draws on specific sets of knowledge, techniques, and organizing principles necessary for the effective management of complex health events. We highlight how the nascent field of PHEM has evolved in recent years. We explore this development by first examining multiple sites of intersection between the fields of public health and emergency management. We then analyze 2 of the principal pillars on which PHEM was built: organizational and programmatic (i.e., industry) standards and the incident management system. This is followed by a sketch of the key domains, or functional areas, of PHEM and their application to the emergency management cycle. We conclude with some observations about PHEM in a global context and discuss how the field might continue to evolve. PMID:28892444

  11. The Evolution of Public Health Emergency Management as a Field of Practice.

    PubMed

    Rose, Dale A; Murthy, Shivani; Brooks, Jennifer; Bryant, Jeffrey

    2017-09-01

    The health impacts of recent global infectious disease outbreaks and other disasters have demonstrated the importance of strengthening public health systems to better protect communities from naturally occurring and human-caused threats. Public health emergency management (PHEM) is an emergent field of practice that draws on specific sets of knowledge, techniques, and organizing principles necessary for the effective management of complex health events. We highlight how the nascent field of PHEM has evolved in recent years. We explore this development by first examining multiple sites of intersection between the fields of public health and emergency management. We then analyze 2 of the principal pillars on which PHEM was built: organizational and programmatic (i.e., industry) standards and the incident management system. This is followed by a sketch of the key domains, or functional areas, of PHEM and their application to the emergency management cycle. We conclude with some observations about PHEM in a global context and discuss how the field might continue to evolve.

  12. [Emergency treatment and management of anaphylaxis].

    PubMed

    Brockow, K; Ring, J

    2013-02-01

    Anaphylaxis, the maximal manifestation of an immediate allergic reaction, is a life-threatening systemic reaction. The immediate therapy is chosen according to the clinical manifestations and new German guidelines are in preparation. Required measures include immediate removal of allergen, adequate positioning, assessment of severity and organ involvement and activation of emergency medical services. In anaphylaxis with primarily cardiovascular involvement, epinephrine is the treatment of choice and given together with volume substitution, oxygen, H(1)-antihistamines and corticosteroids. Obstruction of the airways is treated with intramuscular and inhaled epinephrine, or alternatively β(2)-sympathicomimetics, and oxygen. Abdominal or cutaneous involvement, such as generalized urticaria, usually can be treated with intravenous H(1)-antihistamines, glucocorticoids and surveillance. In patients with anaphylaxis, the elicitor of the reaction has to be diagnosed by allergy testing. Patients with sustained risk for anaphylaxis should receive a self-medication kit and should be educated about behavioral patterns needed for prophylaxis and therapy of anaphylactic reactions. Patient educational intervention increases knowledge about anaphylaxis, and practical competence and thus, is a basis of a successful management of anaphylaxis.

  13. Quality assurance measurement for emergency management

    SciTech Connect

    Pawlowski, M.S.

    1993-12-31

    Under the Federal Civil Defense Act of 1950, as amended, the Federal Emergency Management Agency (FEMA) is charged with maintenance of a nationwide inventory of 4.3 million radiological instruments procured and granted by the federal government to state and local governments. These instruments are used by trained state Radiological Response Team Members, first responders, and critical workers to support the population from a national security or large-scale peacetime radiological disaster, e.g., Chernobyl, Three Mile Island, Satellite Reentry, etc. The inventory is maintained through a network of 100% federally funded state maintenance and calibration facilities, with overall technical guidance and standardization provided by the FEMA Radiological Instrumentation Test Facility. The system used to support maintenance and standardized calibration of the inventory consists of CDV-794 Radiation Calibrator (High Range), CDV-765 Model 2 Gamma Transfer Standard, CDV-790 Model 1 Calibrator (Low Range), and Dosimeter Transfer Standards. Past studies have indicated the {open_quotes}Readiness{close_quotes} and {open_quotes}Reliability{close_quotes} of the inventory to meet mission requirements based upon a standardized system of maintenance and calibration. FEMA has just initiated a new instrument Readiness and Reliability study with the State of Ohio Radiological Instrument Maintenance and Calibration Program to provide data to reassess the capability of the current inventory to support all types of peacetime and national security missions.

  14. Special event planning for the emergency manager.

    PubMed

    Gaynor, Peter T

    2009-11-01

    In the domain of emergency management and homeland security there is a lack of a formal planning process at the local level when it comes to special event planning. The unique nature of special event planning demands an understanding of the planning process for both traditional and non-traditional planning partners. This understanding will make certain that local governments apply due diligence when planning for the safety of the public. This paper offers a practical roadmap for planning at the local level. It will address those 'special events' that are beyond routine local events but not of a sufficient scale to be granted National Special Security Event status. Due to the infrequency of 'special events' in most communities, it is imperative that deliberate planning takes place. Upon conclusion, the reader will be able to construct a planning process tailored to the needs of their community, guide both traditional and non-traditional planning partners through the planning process, determine priorities, explore alternatives, plan for contingencies, conduct a confirmation brief, facilitate operations and assemble an after-action report and improvement plan.

  15. Management of neuro-oncologic emergencies.

    PubMed

    Jo, J T; Schiff, D

    2017-01-01

    Patients with brain tumors and systemic malignancies are subject to diverse neurologic complications that require urgent evaluation and treatment. These neurologic conditions are commonly due to the tumor's direct effects on the nervous system, such as cerebral edema, increased intracranial pressure, seizures, spinal cord compression, and leptomeningeal metastases. In addition, neurologic complications can develop as a result of thrombocytopenia, coagulopathy, hyperviscosity syndromes, infection, immune-related disorders, and adverse effects of treatment. Patients may present with typical disease syndromes. However, it is not uncommon for patients to have more subtle, nonlocalizing manifestations, such as alteration of mental status, that could be attributed to other systemic, nonneurologic complications. Furthermore, neurologic complications are at times the initial manifestations of an undiagnosed malignancy. Therefore a high index of suspicion is essential for rapid assessment and management. Timely intervention may prolong survival and improve quality of life. In this chapter, we will discuss the common neuro-oncologic emergencies, including epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment. © 2017 Elsevier B.V. All rights reserved.

  16. Bedbugs and Infectious Diseases

    PubMed Central

    Blanc, Véronique; Del Giudice, Pascal; Levy-Bencheton, Anna; Chosidow, Olivier; Marty, Pierre; Brouqui, Philippe

    2011-01-01

    Bedbugs are brown and flat hematophagous insects. The 2 cosmopolite species, Cimex lectularius and Cimex hemipterus, feed on humans and/or domestic animals, and recent outbreaks have been reported in occidental countries. Site assessment for bedbug eradication is complex but can be assured, despite emerging insecticide resistance, by hiring a pest-control manager. The common dermatological presentation of bites is an itchy maculopapular wheal. Urticarial reactions and anaphylaxis can also occur. Bedbugs are suspected of transmitting infectious agents, but no report has yet demonstrated that they are infectious disease vectors. We describe 45 candidate pathogens potentially transmitted by bedbugs, according to their vectorial capacity, in the wild, and vectorial competence, in the laboratory. Because of increasing demands for information about effective control tactics and public health risks of bedbugs, continued research is needed to identify new pathogens in wild Cimex species (spp) and insecticide resistance. PMID:21288844

  17. Bedbugs and infectious diseases.

    PubMed

    Delaunay, Pascal; Blanc, Véronique; Del Giudice, Pascal; Levy-Bencheton, Anna; Chosidow, Olivier; Marty, Pierre; Brouqui, Philippe

    2011-01-15

    Bedbugs are brown and flat hematophagous insects. The 2 cosmopolite species, Cimex lectularius and Cimex hemipterus, feed on humans and/or domestic animals, and recent outbreaks have been reported in occidental countries. Site assessment for bedbug eradication is complex but can be assured, despite emerging insecticide resistance, by hiring a pest-control manager. The common dermatological presentation of bites is an itchy maculopapular wheal. Urticarial reactions and anaphylaxis can also occur. Bedbugs are suspected of transmitting infectious agents, but no report has yet demonstrated that they are infectious disease vectors. We describe 45 candidate pathogens potentially transmitted by bedbugs, according to their vectorial capacity, in the wild, and vectorial competence, in the laboratory. Because of increasing demands for information about effective control tactics and public health risks of bedbugs, continued research is needed to identify new pathogens in wild Cimex species (spp) and insecticide resistance.

  18. Urbanization, Agricultural Intensification, and Habitat Alteration in Vietnam: Modeling Transitional Development and Emerging Infectious Diseases

    NASA Astrophysics Data System (ADS)

    Fox, J.; Saksena, S.; Spencer, J.; Finucane, M.; Sultana, N.

    2012-12-01

    Our overarching hypothesis is that new risks, in this case the H5N1 strain of avian influenza, emerge during transitions between stages of development. Moreover, these risks are not coincidental but occur precisely because of the in-between nature of the coupled human-natural system at the point when things are neither traditional nor modern but resemble the state of chaos, release and reorganization. We are testing this hypothesis in Vietnam using demographic, social, economic, and environmental data collected in national censuses and analyzed at commune and district levels to identify communes and districts that are traditional, modern, and transitional (peri-urban). Using data from the 2006 agricultural census that capture both the changing nature of the built environment (types of sanitation systems) and the loss of and diversification of agriculture systems (percent of households whose major source of income is from agriculture, and percent of land under agriculture, forests, and aquaculture), and a normalized difference vegetation index from 2006 Landsat images we created a national scale urbanicity map for Vietnam. Field work in the summer of 2011 showed this map to be an accurate (approximately 85%) approximation of traditional (rural), transitional (periurban), and modern (urban) communes. Preliminary results suggest that over 7% of the country's land area and roughly 15% of its population resides in periurban neighborhoods, and that these areas do have a statistically significant greater incidence of AVI as measured in chicken deaths than traditional and modern communes (Table 1). Transitional neighborhoods such as these force planners to ask two questions. To what extent does the dichotomy of urban/rural makes sense in the context of Vietnam, when large areas and parts of the population are caught between the two? Second, how can planners and policy makers effectively provide for basic public goods and services in these contexts?Classification of places

  19. The Microbial Rosetta Stone Database: A compilation of global and emerging infectious microorganisms and bioterrorist threat agents

    PubMed Central

    Ecker, David J; Sampath, Rangarajan; Willett, Paul; Wyatt, Jacqueline R; Samant, Vivek; Massire, Christian; Hall, Thomas A; Hari, Kumar; McNeil, John A; Büchen-Osmond, Cornelia; Budowle, Bruce

    2005-01-01

    Background Thousands of different microorganisms affect the health, safety, and economic stability of populations. Many different medical and governmental organizations have created lists of the pathogenic microorganisms relevant to their missions; however, the nomenclature for biological agents on these lists and pathogens described in the literature is inexact. This ambiguity can be a significant block to effective communication among the diverse communities that must deal with epidemics or bioterrorist attacks. Results We have developed a database known as the Microbial Rosetta Stone. The database relates microorganism names, taxonomic classifications, diseases, specific detection and treatment protocols, and relevant literature. The database structure facilitates linkage to public genomic databases. This paper focuses on the information in the database for pathogens that impact global public health, emerging infectious organisms, and bioterrorist threat agents. Conclusion The Microbial Rosetta Stone is available at . The database provides public access to up-to-date taxonomic classifications of organisms that cause human diseases, improves the consistency of nomenclature in disease reporting, and provides useful links between different public genomic and public health databases. PMID:15850481

  20. Neglected tropical disease and emerging infectious disease: an analysis of the history, promise and constraints of two worldviews.

    PubMed

    Jackson, Yves; Stephenson, Niamh

    2014-01-01

    Emerging infectious diseases (EIDs) and neglected tropical diseases (NTDs) are medical terms referring to a group of diseases, yet they are simultaneously socio-political constructs (EID and NTD). When viewed as such, public health interest in EID has been criticised as prioritising free market, Global North interests. This paper asks if the recent turn to NTD, which directs attention and resources to 'the bottom billion' of the world's population, addresses the limitations of focusing on EID. Our approach involves comparing the specific socio-political framing, or 'worldview' of NTD, with that of EID. We examine the distinct history, rationales, morals, political and economic tensions and loci of power entailed in each worldview. This analysis suggests that efforts to foreground NTD constitute a site where humanitarian and biomedical industry actors and actions are increasingly blurred. We examine whether the NTD worldview constitutes a break with or a new version of a free market approach to global health, and whether it reworks or solidifies paternalistic Global North-South relations. We consider some of the limits of work on NTD to date, suggesting that although the NTD worldview does not escape the neo-colonial history of global health, it can actualise it under a different form.

  1. Centrality in primate–parasite networks reveals the potential for the transmission of emerging infectious diseases to humans

    PubMed Central

    Gómez, José María; Nunn, Charles L.; Verdú, Miguel

    2013-01-01

    Most emerging infectious diseases (EIDs) in humans have arisen from animals. Identifying high-risk hosts is therefore vital for the control and surveillance of these diseases. Viewing hosts as connected through the parasites they share, we use network tools to investigate predictors of parasitism and sources of future EIDs. We generated host–parasite networks that link hosts when they share a parasite, using nonhuman primates as a model system because—owing to their phylogenetic proximity and ecological overlap with humans—they are an important source of EIDs to humans. We then tested whether centrality in the network of host species—a measurement of the importance of a given node (i.e., host species) in the network—is associated with that host serving as a potential EID source. We found that centrality covaries with key predictors of parasitism, such as population density and geographic range size. Importantly, we also found that primate species having higher values of centrality in the primate–parasite network harbored more parasites identified as EIDs in humans and had parasite communities more similar to those found in humans. These relationships were robust to the use of different centrality metrics and to multiple ways of controlling for variation in how well each species has been studied (i.e., sampling effort). Centrality may therefore estimate the role of a host as a source of EIDs to humans in other multispecific host–parasite networks. PMID:23610389

  2. The epidemiology and surveillance workforce among local health departments in California: mutual aid and surge capacity for routine and emergency infectious disease situations.

    PubMed

    Enanoria, Wayne T A; Crawley, Adam W; Hunter, Jennifer C; Balido, Jeannie; Aragon, Tomas J

    2014-01-01

    Public health surveillance and epidemiologic investigations are critical public health functions for identifying threats to the health of a community. We conducted a survey of local health departments (LHDs) in California to describe the workforce that supports public health surveillance and epidemiologic functions during routine and emergency infectious disease situations. The target population consisted of the 61 LHDs in California. The online survey instrument was designed to collect information about the workforce involved in key epidemiologic functions. We also examined how the public health workforce increases its epidemiologic capacity during infectious disease emergencies. Of 61 LHDs in California, 31 (51%) completed the survey. A wide range of job classifications contribute to epidemiologic functions routinely, and LHDs rely on both internal and external sources of epidemiologic surge capacity during infectious disease emergencies. This study found that while 17 (55%) LHDs reported having a mutual aid agreement with at least one other organization for emergency response, only nine (29%) LHDs have a mutual aid agreement specifically for epidemiology and surveillance functions. LHDs rely on a diverse workforce to conduct epidemiology and public health surveillance functions, emphasizing the need to identify and describe the types of staff positions that could benefit from public health surveillance and epidemiology training. While some organizations collaborate with external partners to support these functions during an emergency, many LHDs do not rely on mutual aid agreements for epidemiology and surveillance activities.

  3. Implementing a One Health approach to emerging infectious disease: reflections on the socio-political, ethical and legal dimensions.

    PubMed

    Degeling, Chris; Johnson, Jane; Kerridge, Ian; Wilson, Andrew; Ward, Michael; Stewart, Cameron; Gilbert, Gwendolyn

    2015-12-29

    'One Health' represents a call for health researchers and practitioners at the human, animal and environmental interfaces to work together to mitigate the risks of emerging and re-emerging infectious diseases (EIDs). A One Health approach emphasizing inter-disciplinary co-operation is increasingly seen as necessary for effective EID control and prevention. There are, however, socio-political, ethical and legal challenges, which must be met by such a One Health approach. Based on the philosophical review and critical analysis of scholarship around the theory and practice of One Health it is clear that EID events are not simply about pathogens jumping species barriers; they are comprised of complex and contingent sets of relations that involve socioeconomic and socio-political drivers and consequences with the latter extending beyond the impact of the disease. Therefore, the effectiveness of policies based on One Health depends on their implementation and alignment with or modification of public values. Despite its strong motivating rationale, implementing a One Health approach in an integrated and considered manner can be challenging, especially in the face of a perceived crisis. The effective control and prevention of EIDs therefore requires: (i) social science research to improve understanding of how EID threats and responses play out; (ii) the development of an analytic framework that catalogues case experiences with EIDs, reflects their dynamic nature and promotes inter-sectoral collaboration and knowledge synthesis; (iii) genuine public engagement processes that promote transparency, education and capture people's preferences; (iv) a set of practical principles and values that integrate ethics into decision-making procedures, against which policies and public health responses can be assessed; (v) integration of the analytic framework and the statement of principles and values outlined above; and (vi) a focus on genuine reform rather than rhetoric.

  4. Action Guide for Emergency Management at Institutions of Higher Education

    ERIC Educational Resources Information Center

    Office of Safe and Drug-Free Schools, US Department of Education, 2010

    2010-01-01

    This "Action Guide for Emergency Management at Higher Education Institutions" has been developed to give higher education institutions a useful resource in the field of emergency management. It is intended for community colleges, four-year colleges and universities, graduate schools, and research institutions associated with higher education…

  5. 75 FR 16623 - Emergency Management for Higher Education Grant Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... their campus-based all-hazards emergency management planning efforts. We intend grant awards under these priorities and requirements to increase the capacity of IHEs to prevent/mitigate, prepare for, respond to... all-hazards emergency management planning efforts within the framework of the four phases of...

  6. Mental health telephone triage: managing psychiatric crisis and emergency.

    PubMed

    Sands, Natisha; Elsom, Stephen; Marangu, Elijah; Keppich-Arnold, Sandra; Henderson, Kathryn

    2013-01-01

    The study aims to identify and articulate how mental health telephone triage (MHTT) clinicians manage psychiatric crisis and emergency via the telephone. An observational design was employed in the study. Wireless headsets were used to observe 197 occasions of MHTT. Clinicians use a range of practical strategies, therapeutic skills, and psychosocial interventions to manage psychiatric crises and emergencies via the telephone. The evidence base for managing psychiatric crisis/emergency in MHTT is minimal. These findings contribute to the MHTT knowledge base and provide evidence-based strategies for high-quality emergency mental health care. © 2012 Wiley Periodicals, Inc.

  7. Assessment of hospital emergency management in the Beijing area.

    PubMed

    Yantao, Xin

    2011-06-01

    In recent years, the number of public health emergencies has increased. Improving hospital emergency management is an important challenge. This is a pilot study intended to assess hospital emergency management in the Beijing area, make recommendations to government health authorities and hospital managers, and offer references for similar studies. This was an observational, cross-sectional survey. Forty-five hospitals in the Beijing area were selected randomly. A self-administered questionnaire was used as a data collection tool. It comprised of three sections: (1) Section A was the introduction; (2) Section B asked for the respondent's personal information; and (3) Section C comprised the major part of the questionnaire and was intended to gather information regarding the hospital's general emergency management situation. The survey response rate was 44%, accounting for 29% of total hospitals that the study targeted. No hospital had an established emergency management department or full-time staff for emergency management. A total of 15-45% of the hospitals had established a hospital emergency management committee, performed a vulnerability analysis, or evaluated emergency management regularly. Twenty-five percent of respondents thought that the local government health authority had established an integrated hospital incident command system. A total of 40%-55% of hospitals contracted with outside institutions for supplements, backup of key functional systems and professional support. After the occurrence of the 2003 severe acute respiratory syndrome (SARS) epidemic, Chinese hospital managers took many measures to improve hospital resilience. However, most of these efforts lacked the guidance of theories, concepts, principles, and methods. An integrated, standardized, operational hospital emergency management model has not been established. Although the survey response rate was relatively low, some clues for further study were discovered, and suggestions to the

  8. Impact of infectious diseases consultation on the management of Staphylococcus aureus bacteraemia in children.

    PubMed

    Saunderson, Rebecca B; Gouliouris, Theodore; Cartwright, Edward J; Nickerson, Emma J; Aliyu, Sani H; O'Donnell, D Roddy; Kelsall, Wilf; Limmathurotsakul, D; Peacock, Sharon J; Török, M Estée

    2014-07-01

    Infectious diseases consultation (IDC) in adults with Staphylococcus aureus bacteraemia (SAB) has been shown to improve management and outcome. The aim of this study was to evaluate the impact of IDC on the management of SAB in children. Observational cohort study of children with SAB. Cambridge University Hospitals National Health Service (NHS) Foundation Trust, a large acute NHS Trust in the UK. All children with SAB admitted to the Cambridge University Hospitals NHS Foundation Trust between 16 July 2006 and 31 December 2012. Children with SAB between 2006 and 31 October 2009 were managed by routine clinical care (pre-IDC group) and data were collected retrospectively by case notes review. An IDC service for SAB was introduced in November 2009. All children with SAB were reviewed regularly and data were collected prospectively (IDC group) until 31 December 2012. Baseline characteristics, quality metrics and outcome were compared between the pre-IDC group and IDC group. There were 66 episodes of SAB in 63 children-28 patients (30 episodes) in the pre-IDC group, and 35 patients (36 episodes) in the IDC group. The median age was 3.4 years (IQR 0.2-10.7 years). Patients in the IDC group were more likely to have echocardiography performed, a removable focus of infection identified and to receive a longer course of intravenous antimicrobial therapy. There were no differences in total duration of antibiotic therapy, duration of hospital admission or outcome at 30 or 90 days following onset of SAB. IDC resulted in improvements in the investigation and management of SAB in children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Implementation of an Infectious Disease Fellow-Managed Penicillin Allergy Skin Testing Service.

    PubMed

    Heil, Emily L; Bork, Jacqueline T; Schmalzle, Sarah A; Kleinberg, Michael; Kewalramani, Anupama; Gilliam, Bruce L; Buchwald, Ulrike K

    2016-09-01

    Background.  A large percentage of patients presenting to acute care facilities report penicillin allergies that are associated with suboptimal antibiotic therapy. Penicillin skin testing (PST) can clarify allergy histories but is often limited by access to testing. We aimed to implement an infectious diseases (ID) fellow-managed PST program and to assess the need for PST via national survey. Methods.  We conducted a prospective observational study of the implementation of an ID fellow-managed penicillin allergy skin testing service. The primary outcome of the study was to assess the feasibility and acceptability of an ID fellow-managed PST service and its impact on the optimization of antibiotic selection. In addition, a survey of PST practices was sent out to all ID fellowship program directors in the United States. Results.  In the first 11 months of the program, 90 patients were assessed for PST and 76 patients were tested. Of the valid tests, 96% were negative, and 84% with a negative test had antibiotic changes; 63% received a narrower spectrum antibiotic, 80% received more effective therapy, and 61% received more cost-effective therapy. The majority of survey of respondents (n = 50) indicated that overreporting of penicillin allergy is a problem in their practice that affects antibiotic selection but listed inadequate personnel and time as the main barriers to PST. Conclusions.  Inpatient PST can be successfully managed by ID fellows, thereby promoting optimal antibiotic use in patients reporting penicillin allergies. This model can increase access to PST at institutions without adequate access to allergists while also providing an important educational experience to ID trainees.

  10. Infectious diseases among foreign prisoners: results of a hospital-based management model in Palermo.

    PubMed

    Prestileo, Tullio; Spicola, Daria; Di Lorenzo, Francesco; Dalle Nogare, Ernesto Renato; Sanfilippo, Adriana; Ficalora, Antonio; Corrao, Salvatore

    2017-03-01

    Foreign prisoners have a high vulnerability in terms of morbidity and access to care in overcrowded Italian prisons. This paper presents and comments on the management model of infectious diseases in foreign prisoners at our outpatient clinic, in order to describe a model of management for these conditions. Overall, 133 subjects (mean age 35.5 years) from 29 countries were followed for a period of 15 years. The most commonly represented area of origin (54.1%) was the Maghreb region. HCV infection (40.6%), HIV (22.5%), HBV (9.8%) and co-infection (15%, HIV/HCV or HIV/HBV) were observed. Ten subjects had tuberculosis, and only 30% of them were compliant with the treatment. Only 46.3% of HCV mono-infected patients completed the entire diagnostic process and even a lower percentage (37%) of them took treatment regularly. 90% of HBV mono-infected patients and 84% of those HIV mono- and co-infected completed the diagnostic workout. 77% of patients in each group took therapy regularly. Overall, the results show limited effectiveness. Therefore, it would be necessary to improve communication between healthcare professionals and correctional systems. Moreover, it appears urgent to reduce overcrowding in prisons to limit morbidity in prisoners.

  11. Information management in the emergency department.

    PubMed

    Taylor, Todd B

    2004-02-01

    Information system planning for the ED is complex and new to emergency medicine, despite being used in other industries for many years. It has been estimated that less than 15% of EDs have comprehensive EDIS currently in place. The manner in which administration is approached in large part determines the success in obtaining appropriate institutional support for an EDIS. Active physician and nurse involvement is essential in the process if the new system is to be accepted at the user level. In the ED, large volumes of information are collected, collated,interpreted, and acted on immediately. Effective information management therefore is key to the successful operation of any ED. Although computerized information systems have tremendous potential for improving information management, such systems are often underused or implemented in such a way that they increase the workload on caregivers and staff. This is counter productive and should be avoided. In developing and implementing EDIS one should be careful not to automate poorly designed manual processes. Examples are ED tracking systems that require staff to manually relocate patients in the system. This task probably is completed only when the ED volume is low and "worked around" when the department is busy. Information from such a system is, therefore, flawed; at best useless and at worst counter productive. Alternatively, systems are available that can track patients automatically through the ED by way of infrared sensors similar to those used in baggage-tracking systems that have been in place in airports for years. In the automated (computerized) ED, we must have zero-fault-tolerant,enterprise-wide, hospital information networked systems that prevent unnecessary duplication of tasks, assist in tracking and entering data, and ultimately help analyze the information on a minute-to-minute basis. Such systems only reach their potential when they are fully integrated, including legacy systems, rather than stand

  12. Municipal resilience: A paradigm shift in emergency and continuity management.

    PubMed

    Solecki, Greg; Luchia, Mike

    More than a decade of emergency and continuity management vision was instrumental in providing the unprecedented level of response and recovery from the great flood of 2013. Earlier assessments, planning and validation promulgated development of corporate continuity, emergency and contingency plans along with tactical, strategic and recovery operations centres that all led to a reliable emergency management model that will continue to provide the backbone for municipal resilience.

  13. Conservation, development and the management of infectious disease: avian influenza in China, 2004-2012.

    PubMed

    Wu, Tong; Perrings, Charles

    2017-06-05

    There is growing evidence that wildlife conservation measures have mixed effects on the emergence and spread of zoonotic disease. Wildlife conservation has been found to have both positive (dilution) and negative (contagion) effects. In the case of avian influenza H5N1 in China, the focus has been on negative effects. Lakes and wetlands attracting migrating waterfowl have been argued to be disease hotspots. We consider the implications of waterfowl conservation for H5N1 infections in both poultry and humans between 2004 and 2012. We model both environmental and economic risk factors. Environmental risk factors comprise the conditions that structure interaction between wild and domesticated birds. Economic risk factors comprise the cost of disease, biosecurity measures and disease risk mitigation. We find that H5N1 outbreaks in poultry populations are indeed sensitive to the existence of wild-domesticated bird mixing zones, but not in the way we would expect from the literature. We find that risk is decreasing in protected migratory bird habitat. Since the number of human cases is increasing in the number of poultry outbreaks, as expected, the implication is that the protection of wetlands important for migratory birds offers unexpected human health benefits.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Author(s).

  14. Establishing functional requirements for emergency management information systems

    SciTech Connect

    Reed, J.H.; Rogers, G.O.; Sorensen, J.H.

    1991-01-01

    The advancement of computer technologies has led to the development of a number of emergency management information systems (e.g., EIS, CAMEO, IEMIS). The design of these systems has tended to be technologically driven rather than oriented to meeting information management needs during an emergency. Of course, emergency management needs vary depending on the characteristics of the emergency. For example, in hurricanes, onset is typically slow enough to allow emergency managers to simulate evacuations dynamically while in chemical disasters onset may be sufficiently rapid to preclude such simulation(s). This paper describes a system design process in which the analysis of widely recognized emergency management functions was used to identify information requirements and the requisite software and hardware capabilities to deal with rapid onset, low probability, high consequence events. These requirements were then implemented as a prototype emergency management system using existing hardware and software to assure feasibility. Data, hardware, and software requirements were further developed, refined, and made more concrete through an iterative prototyping effort. This approach focuses attention directly on meeting emergency management information needs while avoiding unneeded technological innovations. 10 refs., 4 figs., 1 tab.

  15. Practices and challenges of infectious waste management: A qualitative descriptive study from tertiary care hospitals in Pakistan

    PubMed Central

    Kumar, Ramesh; Shaikh, Babar Tasneem; Somrongthong, Ratana; Chapman, Robert S

    2015-01-01

    Background and Objective: Infectious waste management practices among health care workers in the tertiary care hospitals have been questionable. The study intended to identify issues that impede a proper infectious waste management. Methods: Besides direct observation, in-depths interviews were conducted with the hospital administrators and senior management involved in healthcare waste management during March 2014. We looked at the processes related to segregation, collection, storage and disposal of hospital waste, and identified variety of issues in all the steps. Results: Serious gaps and deficiencies were observed related to segregation, collection, storage and disposal of the hospital wastes, hence proving to be hazardous to the patients as well as the visitors. Poor safety, insufficient budget, lack of trainings, weak monitoring and supervision, and poor coordination has eventually resulted in improper waste management in the tertiary hospitals of Rawalpindi. Conclusion: Study has concluded that the poor resources and lack of healthcare worker’s training in infectious waste results in poor waste management at hospitals. PMID:26430405

  16. Steps for Developing a School Emergency Management Plan. Helpful Hints for School Emergency Management. Volume 2, Issue 1

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    The U.S. Department of Education's Office of Safe and Drug-Free Schools strongly encourages schools and school districts to develop emergency management plans within the context of the four phases of emergency management: prevention, mitigation, preparedness, response and recovery. In addition, schools should collaborate closely with police, fire…

  17. Containment Care Units for Managing Patients With Highly Hazardous Infectious Diseases: A Concept Whose Time Has Come.

    PubMed

    Kortepeter, Mark G; Kwon, Elena H; Hewlett, Angela L; Smith, Philip W; Cieslak, Theodore J

    2016-10-15

    The concept of containment care for patients with highly hazardous infectious diseases originated in conjunction with the development of sophisticated biosafety level 4 laboratories at the US Army Medical Research Institute of Infectious Diseases in the late 1960s. Over time, the original containment facility served as a model for the development of other facilities in the United States at government and academic centers. The Ebola outbreak of 2014-2015 brought the issue of containment care into the mainstream and led to the development of such capabilities at strategic points around the country. We describe the original concepts behind development of such facilities, how the concept and acceptance has evolved over time, and how the guidelines for managing patients infected with viral hemorrhagic fevers have evolved as new information has been learned about protecting medical care providers from highly hazardous infectious pathogens.

  18. Multivariate analysis of traditional pig management practices and their potential impact on the spread of infectious diseases in Corsica.

    PubMed

    Relun, A; Charrier, F; Trabucco, B; Maestrini, O; Molia, S; Chavernac, D; Grosbois, V; Casabianca, F; Etter, E; Jori, F

    2015-10-01

    Corsica is a French Mediterranean island with traditional extensive pig farming oriented towards the production of high quality cured meat products. The increasing success of these cured products in continental Europe has triggered the development and organisation of an extensive pig farming industry. However, these pig farming practices have seldom been described and analysed to understand the potential risk of introduction and spread of infectious diseases. We conducted a cross-sectional study in Corsica in 2013 to characterise the main pig management practices and to identify groups of farms with similar practices and therefore homogeneous risk of introduction and spread of infectious diseases. We interviewed 68 pig farmers and investigated different farm management practices which could lead to contact between herds, such as trading animals, sharing pastures, feed and reproduction management (direct contacts), slaughtering and carcass waste management, and contacts with people and vehicles (indirect contacts). The practices were described and the farms grouped by multiple factor and hierarchical clustering analyses. Results revealed interesting patterns in the introduction and spread of infectious disease, such as the seasonality of pig production, the potential local spread of diseases in pastures due to the presence of free-ranging boars, carcasses, and animal waste. Multivariate analyses identified four groups of farms with different levels of risk of the spread of infectious disease, illustrating changes in farmers' customs from free-range uncontrolled farming systems to more controlled systems aimed at the production of high quality pork products. These results will be useful to more realistically simulate the spread of infectious diseases among Corsican pig farms and highlight the need for awareness raising campaigns among the stakeholders to reduce risky practices.

  19. Emergency inventory management for disasters--a review.

    PubMed

    Ozguven, Eren Erman; Ozbay, Kaan

    2014-01-01

    There has been a recent surge in the publication of academic literature examining various aspects of emergency inventory management for disasters. This article contains a timely literature review of these studies, beginning with an exposition of the characteristics of storage and delivery options for emergency supplies, with a particular emphasis on the differences between emergency inventories and conventional inventory management. Using a novel classification scheme and a comprehensive search of the inventory related literature, an overview of the emergency inventory management studies is also presented. Finally, based on this extensive review, a discussion is presented based on the critical issues and key findings related to the emergency inventory management field, and include suggestions for future research directions.

  20. The Emerging Phenomenon of Knowledge Management.

    ERIC Educational Resources Information Center

    Broadbent, Marianne

    1997-01-01

    Clarifies the meaning of knowledge management and gives examples of organizations that overtly practice it. Outlines four steps in knowledge management: (1) making knowledge visible; (2) building knowledge intensity; (3) building knowledge infrastructure; and (4) developing a knowledge culture. Discusses managing people as assets, librarians as…

  1. The Emerging Phenomenon of Knowledge Management.

    ERIC Educational Resources Information Center

    Broadbent, Marianne

    1997-01-01

    Clarifies the meaning of knowledge management and gives examples of organizations that overtly practice it. Outlines four steps in knowledge management: (1) making knowledge visible; (2) building knowledge intensity; (3) building knowledge infrastructure; and (4) developing a knowledge culture. Discusses managing people as assets, librarians as…

  2. Model-Informed Risk Assessment and Decision Making for an Emerging Infectious Disease in the Asia-Pacific Region

    PubMed Central

    Moss, Robert; Hickson, Roslyn I.; McVernon, Jodie; McCaw, James M.; Hort, Krishna; Black, Jim; Madden, John R.; Tran, Nhi H.; McBryde, Emma S.

    2016-01-01

    Background Effective response to emerging infectious disease (EID) threats relies on health care systems that can detect and contain localised outbreaks before they reach a national or international scale. The Asia-Pacific region contains low and middle income countries in which the risk of EID outbreaks is elevated and whose health care systems may require international support to effectively detect and respond to such events. The absence of comprehensive data on populations, health care systems and disease characteristics in this region makes risk assessment and decisions about the provision of such support challenging. Methodology/principal findings We describe a mathematical modelling framework that can inform this process by integrating available data sources, systematically explore the effects of uncertainty, and provide estimates of outbreak risk under a range of intervention scenarios. We illustrate the use of this framework in the context of a potential importation of Ebola Virus Disease into the Asia-Pacific region. Results suggest that, across a wide range of plausible scenarios, preemptive interventions supporting the timely detection of early cases provide substantially greater reductions in the probability of large outbreaks than interventions that support health care system capacity after an outbreak has commenced. Conclusions/significance Our study demonstrates how, in the presence of substantial uncertainty about health care system infrastructure and other relevant aspects of disease control, mathematical models can be used to assess the constraints that limited resources place upon the ability of local health care systems to detect and respond to EID outbreaks in a timely and effective fashion. Our framework can help evaluate the relative impact of these constraints to identify resourcing priorities for health care system support, in order to inform principled and quantifiable decision making. PMID:27661978

  3. The Utility of Preliminary Patient Evaluation in a Febrile Respiratory Infectious Disease Unit outside the Emergency Department.

    PubMed

    Kang, Jun Sik; Jhun, Byung Woo; Yoon, Hee; Lim, Seong Mi; Ko, Eunsil; Park, Joo Hyun; Hwang, Sung Yeon; Lee, Se Uk; Lee, Tae Rim; Cha, Won Chul; Shin, Tae Gun; Sim, Min Seob; Jo, Ik Joon

    2017-09-01

    A febrile respiratory infectious disease unit (FRIDU) with a negative pressure ventilation system was constructed outside the emergency department (ED) of the Samsung Medical Center in 2015, to screen for patients with contagious diseases requiring isolation. We evaluated the utility of the FRIDU during 1 year of operation. We analyzed 1,562 patients who were hospitalized after FRIDU screening between August 2015 and July 2016. The level of isolation recommended during their screening at the FRIDU was compared with the level deemed appropriate given their final diagnosis. Of the 1,562 patients screened at the FRIDU, 198 (13%) were isolated, 194 (12%) were reverse isolated, and 1,170 (75%) were not isolated. While hospitalized, 97 patients (6%) were confirmed to have a contagious disease requiring isolation, such as tuberculosis; 207 patients (13%) were confirmed to be immunocompromised and to require reverse isolation, mainly due to neutropenia; and the remaining 1,258 patients (81%) did not require isolation. The correlation coefficient for isolation consistency was 0.565 (P < 0.001). The sensitivity and negative predictive value of FRIDU screening for diagnosing contagious disease requiring isolation are 76% and 98%, respectively. No serious nosocomial outbreaks of contagious diseases occurred. During FRIDU screening, 114 patients were admitted to the resuscitation zone due to clinical instability, and three of these patients died. The initial isolation levels resulting from FRIDU screening were moderately well correlated with the isolation levels required by the final diagnosis, demonstrating the utility of pre-hospitalization screening units. However, the risks of deterioration during the screening process remain challenges. © 2017 The Korean Academy of Medical Sciences.

  4. Management of acute infectious diarrhea for children living in resource-limited settings.

    PubMed

    O'Ryan G, Miguel; Ashkenazi-Hoffnung, Liat; O'Ryan-Soriano, Miguel A; Ashkenazi, Shai

    2014-05-01

    Acute infectious gastroenteritis continues to be a leading cause of morbidity and mortality in children below 5 years of age, with the majority of deaths concentrated in 35 'low income' countries. In these countries the under five years of age mortality rates reach 100 per 1000 live births, of which a significant proportion are associated with acute diarrhea. Rotavirus, cryptosporidium, Shigella spp and enterotoxigenic Escherichia coli are the main pathogens causing disease in these settings, although other bacteria and parasites can cause moderate to severe disease in different regions and situations. Treatment of children in these setting should be focused on appropriate rehydration, early hospitalization of severely malnourished children, zinc supplementation, and in specific situations, antimicrobials should be considered. The rationale for antimicrobial use should be based on the potential benefits based on published literature and the opportunity for use. This review provides a pathogen-specific update on the potential benefits of antimicrobials and suggests an empirical management approach for children suffering an acute watery or bloody diarrhea in a resource-limited region.

  5. How to manage the infectious risk under anti-TNF in inflammatory bowel disease.

    PubMed

    Culver, Emma L; Travis, Simon P L

    2010-02-01

    The advent of biological therapy has had a significant impact on the management of patients with inflammatory bowel disease. Nevertheless, anti-TNF-alpha agents are still used with caution, driven by concerns about the risk of infection. Stringent post-marketing surveillance programmes and registries have allowed early recognition of problems, highlighting an increased risk of infectious complications. Although the focus is on biological drugs, other immunomodulators have been less well scrutinised and similarly carry considerable risks of infection. It remains unclear whether the risk of infection from anti-TNF therapy is any different from conventional immunomodulators such as azathioprine or methotrexate, although it appears to be less than that ascribed to corticosteroids. The majority of patients on anti-TNF agents are on concomitant immunosuppressive medication, which makes ascribing risk to a specific drug more difficult. The risk of life-threatening opportunistic infections associated with anti-TNF therapy has obliged us to re-consider methods of prevention of infection and to develop guidelines for risk-stratification of patients with a diagnosis of inflammatory bowel disease. This encompasses vaccination and chemoprevention, appropriate treatment of underlying infection, patient education, travel advice and careful monitoring whilst on anti-TNF therapy. Contingency planning is essential. Implementing these preventative strategies will have an appreciable impact on the organisation of care and on current clinical practice.

  6. Elk restoration in Ontario, Canada: infectious disease management strategy, 1998-2001.

    PubMed

    Rosatte, R; Hamr, J; Ranta, B; Young, J; Cool, N

    2002-10-01

    Ontario has embarked upon a program to restore elk (Cervus elaphus) that were once native to that province. A comprehensive disease-management strategy has ensured that elk are free of infectious diseases such as brucellosis and tuberculosis prior to shipment to Ontario. Postmortem analysis occurs on elk mortalities in Ontario to ensure that elk are not infected with diseases such as chronic wasting disease and tuberculosis. Between 1998 and 2001, a total of 443 elk were transported from Elk Island National Park, Alberta, and released in four different areas of Ontario. Cumulative mortality for elk in all areas was 26% from 1998 to January 2001. The primary causes of mortality were post-release stress-induced emaciation (21%), wolf predation (20%), transport/handling injuries (10%), bacterial infections (10%), and drowning (7%). Female calves had the highest mortality rates (37%) compared to the other sex and age cohorts (23-24%). Preliminary findings suggest an inverse correlation between the length of time elk are held in enclosures prior to release and the distance they disperse from the release site. The 2001 estimated population of elk in Ontario is about 400 individuals.

  7. Evolving prehospital, emergency department, and "inpatient" management models for geriatric emergencies.

    PubMed

    Carpenter, Christopher R; Platts-Mills, Timothy F

    2013-02-01

    Alternative management methods are essential to ensure high-quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols to support early condition-specific treatment of older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to address the influence of other factors on the patient's health. This article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care.

  8. Evaluation of Anaphylaxis Management in a Pediatric Emergency Department.

    PubMed

    Sidhu, Natasha; Jones, Stacie; Perry, Tamara; Thompson, Tonya; Storm, Elizabeth; Melguizo Castro, Maria S; Nick, Todd G

    2016-08-01

    In 2006, the National Institute of Allergy and Infectious Disease established evidence-based treatment guidelines for anaphylaxis. The purpose of our study was to evaluate provider adherence to guidelines-based management for anaphylaxis in a tertiary care pediatric emergency department (ED). Retrospective chart review was conducted of patients (0-18 years) presenting to the Arkansas Children Hospital ED from 2004 to 2011 for the treatment of anaphylaxis using International Classification of Diseases, Ninth Edition, codes. Multiple characteristics including demographics, clinical features, allergen source, and anaphylaxis management were collected. Fisher exact or χ tests were used to compare proportion of patients treated with intramuscular (IM) epinephrine in the preguideline versus postguideline period. Relative risk (RR) statistics were computed to estimate the ratio of patients who received self-injectable epinephrine prescription and allergy follow-up in the preguideline and postguideline groups. A total of 187 patients (median [range] age, 7 [1-18] years; 67% male; 48% African American) were evaluated. Food (44%) and hymenoptera stings (22%) were commonly described culprit allergens, whereas 29% had no identifiable allergen. Only 47% (n = 87) received epinephrine in the ED and 31% (n = 27) via the preferred IM route. Comparing postguideline (n = 126) versus preguideline (n = 61) periods demonstrated increase in the usage of the IM route (46% postguideline vs 6% preguideline; risk ratio (RR), 7.64; 95% confidence interval [CI], 2.04-46.0; P < 0.001). Overall, 61% (n = 115) of the patients received self-injectable epinephrine upon discharge, and there were no significant differences between the groups (64% postguideline vs 56% preguideline, P = 0.30). Postguideline patients were more likely to receive a prescription compared with preguideline patients (64% postguideline vs 56% preguideline; RR, 1.15; 95% CI, 0.89-1.55; P = 0.30). Only 45% (n = 85) received an

  9. Behavioral health emergencies managed by school nurses working with adolescents.

    PubMed

    Ramos, Mary M; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy

    2013-10-01

    As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health emergencies managed by school nurses. We used data from a New Mexico public school nurse workforce survey to describe the involvement of school nurses in managing adolescent behavioral health emergencies. We included all respondents who self-identified as working in a secondary school (N = 186). We conducted descriptive analyses. Two thirds of survey respondents had provided emergency management in the prior school year for child abuse or neglect, depression, and violence at school. Over 40% had provided emergency management for a suicidal student in the prior school year. Although almost 80% of respondents identified "violence at school" as a very important continuing education topic, 40% reported having received continuing education on this topic in the prior 5 years. In New Mexico, public school nurses provide substantial amounts of emergency management for adolescent behavioral health problems. Continuing education received by school nurses on behavioral health emergencies may not be commensurate with their clinical responsibilities. © 2013, American School Health Association.

  10. 44 CFR Appendix A to Part 62 - Federal Emergency Management Agency, Federal Insurance Administration, Financial Assistance...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Federal Emergency Management... 62 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND... OF CLAIMS Pt. 62, App. A Appendix A to Part 62—Federal Emergency Management Agency, Federal...

  11. Polyclonal immunoglobulins and hyperimmune globulins in prevention and management of infectious diseases.

    PubMed

    Hsu, Jennifer L; Safdar, Nasia

    2011-12-01

    Immunoglobulin therapy has a rich history of use in preventing and treating infectious diseases; however, clinical data on the efficacy of immunoglobulin is lacking for many infectious diseases. Immunoglobulin therapy is routinely used in postexposure prophylaxis for bacterial infections, including tetanus, botulism, and diphtheria, and viral infections, including hepatitis A and B and varicella. Immunoglobulin therapy has also been used in many severe and life-threatening infections where treatments are limited, including toxic shock syndrome, respiratory syncytial virus infection, and cytomegalovirus infection. The authors review the evidence for the use of immunoglobulin therapy in common adult infectious diseases. Copyright © 2011. Published by Elsevier Inc.

  12. Emergency Department Management Of Acute Infective Endocarditis.

    PubMed

    Schauer, Steven G; Pfaff, James A; Cuenca, Peter John

    2014-11-01

    Infective endocarditis has a high rate of mortality, and most patients suspected of having the disease will require hospital admission. This review examines the literature as it pertains specifically to emergency clinicians who must maintain vigilance for risk factors and obtain a thorough history, including use of intravenous drugs, in order to guide the workup and treatment. Properly obtained cultures are critical during the evaluation, as they direct the course of antibiotic therapy. Although transthoracic echocardiography is widely available in United States emergency departments, it is not sensitive or specific enough to rule out a diagnosis of infective endocarditis. In high-risk patients, transesophageal echocardiography should be considered.

  13. The attitudes and awareness of emergency department (ED) physicians towards the management of common dentofacial emergencies.

    PubMed

    Trivedy, Chetan; Kodate, Naonori; Ross, Alastair; Al-Rawi, Harrith; Jaiganesh, Thiagarajan; Harris, Tim; Anderson, Janet E

    2012-04-01

    Dentofacial emergencies are a common presentation to the emergency department (ED) but there is little recent data on physicians' knowledge, confidence and attitudes in handling these cases. A questionnaire was administered to 103 ED physicians. The sample was primarily drawn from London hospitals as well a smaller contribution from around the UK and included physicians with a range of experience and at different grades. The majority of the 102 participants (76.5%) did not receive any formal training in managing dentofacial emergencies. The percentage of participants who were happy to manage common dentofacial emergencies is as follows: dental trauma (20.4%); major facial trauma (39.8%); interpreting facial X-rays (68.0%); and facial suturing (85.4%). When questioned 12.1% of the participants felt that ED physicians should be responsible for managing dental emergencies compared to 22.4% who felt that ED physicians should manage maxillofacial emergencies. Only 3.9% of the participants would opt to be treated by an ED doctor in the event of them presenting to the ED with a dental injury. The remaining 72.5% would prefer to be seen by a maxillofacial surgeon, 23.5% by a dentist and none of the participants opted to be seen by the emergency nurse practitioner. ED physicians do not feel confident in managing some dentofacial emergencies. This may be attributed to a lack of training in this area as well as exposure to these types of emergencies. There is a need for greater awareness, validated guidelines and training resources for ED physicians to treat dentofacial emergencies as well more research in this field of emergency medicine. © 2011 John Wiley & Sons A/S.

  14. How do emergency managers use social media platforms?

    PubMed

    Bennett, DeeDee M

    2014-01-01

    Social media platforms are increasingly becoming a useful tool for victims, humanitarians, volunteers, and the general public to communicate during disasters. Research has shown that there are multiple advantages to using social media and the applicability of these platforms crosses several different types of disasters (human-caused, natural, and terrorist) here in the United States and abroad. However, some emergency management agencies have been reluctant to use social media as one of their many communications tools. In this study, the usefulness of social media for emergency management was examined over a 30-day period following a series of tornadoes. Using an observational approach, the public posts disseminated from an emergency management agency were analyzed to determine how two social media platforms were used. The findings show how emergency management agencies could leverage the connectedness of social media to reach victims and make unlikely partnerships.

  15. SecureCore Security Architecture: Authority Mode and Emergency Management

    DTIC Science & Technology

    2007-10-16

    Dan C. Boger Department of Computer Science Interim Associate Provost and...Emergency Management 13 V. References [1] Boneh , D. and Franklin, M. “Identity based encryption from the Weil pairing.” SIAM J. of Computing, Vol. 32

  16. Increasing access and support for emergency management higher education programs.

    PubMed

    Cwiak, Carol L

    2014-01-01

    The number of emergency management higher education programs has grown dramatically since 1994 when the FEMA Higher Education Program was created to propagate and support such growth. Data collected annually since 2007 from emergency management higher education programs shows that these programs face some consistent challenges. These challenges were coupled with annual data on program access and support indicators via dimensional analysis to answer the questions: To what extent are the challenges linked to a lack of access or support? If there is linkage, what can be gleaned from these linkages that can help address the challenges through improving access and support? The analysis showed that lack of access to funding and resources, and lack of support from partner organizations, has an impact on emergency management higher education. Discussion of that impact is followed with detailed recommendations that are focused on strengthening both internal and external access and support relationships for emergency management higher education programs.

  17. Chemical Biological Emergency Management Information System

    SciTech Connect

    2004-06-15

    CB-EMIS is designed to provide information and analysis to transit system operators and emergency responders in the event of a chemical attack on a subway system. The software inforporates detector data, video images, train data, meteorological data, and above- and below-ground plume dispersion models, hight of the liquid level.

  18. Challenges for lupus management in emerging countries.

    PubMed

    Tazi Mezalek, Zoubida; Bono, Wafaa

    2014-06-01

    In emerging countries, systemic lupus erythematosus (SLE) has been associated with several unfavorable outcomes including disease activity, damage accrual, work disability and mortality. Poor socioeconomic status (SES) and lack of access to healthcare, especially in medically underserved communities, may be responsible for many of the observed disparities. Diagnostic delay of SLE or for severe organ damages (renal involvement) have a negative impact on those adverse outcomes in lupus patients who either belong to minority groups or live in emerging countries. Longitudinal and observational prospective studies and registries may help to identify the factors that influence poor SLE outcomes in emerging countries. Infection is an important cause of mortality and morbidity in SLE, particularly in low SES patients and tuberculosis appears to be frequent in SLE patients living in endemic areas (mainly emerging countries). Thus, tuberculosis screening should be systematically performed and prophylaxis discussed for patients from these areas. SLE treatment in the developing world is restricted by the availability and cost of some immunosuppressive drugs. Moreover, poor adherence has been associated to bad outcomes in lupus patients with a higher risk of flares, morbidity, hospitalization, and poor renal prognosis. Low education and the lack of money are identified as the main barrier to improve lupus prognosis. Newer therapeutic agents and new protocols had contributed to improve survival in SLE. The use of corticoid-sparing agents (hydroxychloroquine, methotrexate, azathioprine and mycophenolate mofetif) is one of the most useful strategy; availability of inexpensive generics may help to optimize access to these medications.

  19. MS ANTWERPEN: Emergency Management Training for Low-Risk Environments

    ERIC Educational Resources Information Center

    Strohschneider, Stefan; Gerdes, Jurgen

    2004-01-01

    Emergency management training programs have been developed mostly for trainees from high-risk environments such as aviation or the chemical industry. This article describes a training program for staff members from low-risk environments such as hospitals or hotels, where the awareness of potential dangers is usually low and emergency plans are…

  20. The Role of Spatial Information Systems in Environmental Emergency Management.

    ERIC Educational Resources Information Center

    Mondschein, Lawrence G.

    1994-01-01

    Reviews the use of spatial data and information technology by environmental managers and emergency responders. Discussion includes environmental legislation, the Toxic Chemical Release Inventory (TRI) database, public access to environmental information, information standardization problems, emergency response software development and a case study…

  1. Recommendations for Emergency Management Planning for School Facilities.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    Numerous events, such as hurricanes, floods, and tornadoes, constitute a natural disaster for public schools. Human-caused disasters include hazardous-material emergencies, civil riots, fires, and nuclear accidents. This document contains emergency-management planning guidelines, developed by the Texas Education Agency, to help local school…

  2. MS ANTWERPEN: Emergency Management Training for Low-Risk Environments

    ERIC Educational Resources Information Center

    Strohschneider, Stefan; Gerdes, Jurgen

    2004-01-01

    Emergency management training programs have been developed mostly for trainees from high-risk environments such as aviation or the chemical industry. This article describes a training program for staff members from low-risk environments such as hospitals or hotels, where the awareness of potential dangers is usually low and emergency plans are…

  3. Rodent-borne infectious disease outbreaks after flooding disasters: Epidemiology, management, and prevention.

    PubMed

    Diaz, James H

    2015-01-01

    To alert clinicians to the climatic conditions that can precipitate outbreaks of the rodent-borne infectious diseases most often associated with flooding disasters, leptospirosis (LS), and the Hantavirus-caused diseases, hemorrhagic fever with renal syndrome (HFRS) and Hantavirus pulmonary syndrome (HPS); to describe the epidemiology and presenting clinical manifestations and outcomes of these rodent-borne infectious diseases; and to recommend both prophylactic therapies and effective control and prevention strategies for rodent-borne infectious diseases. Internet search engines, including Google®, Google Scholar®, Pub Med, Medline, and Ovid, were queried with the key words as search terms to examine the latest scientific articles on rodent-borne infectious disease outbreaks in the United States and worldwide to describe the epidemiology and presenting clinical manifestations and outcomes of LS and Hantavirus outbreaks. Not applicable. Not applicable. Not applicable. Rodent-borne infectious disease outbreaks following heavy rainfall and flooding disasters. Heavy rainfall encourages excessive wild grass seed production that supports increased outdoor rodent population densities; and flooding forces rodents from their burrows near water sources into the built environment and closer to humans. Healthcare providers should maintain high levels of suspicion for LS in patients developing febrile illnesses after contaminated freshwater exposures following heavy rainfall, flooding, and even freshwater recreational events; and for Hantavirus-caused infectious diseases in patients with hemorrhagic fevers that progress rapidly to respiratory or renal failure following rodent exposures.

  4. Federal Emergency Management Agency: An Organization Prepared

    DTIC Science & Technology

    2008-12-12

    time, FEMA continued its efforts and the Department of Housing and Urban Development (DHUD) made funds available for “ buyouts ” to encourage...many that has completely changed FEMA’s approach to disaster management. Today, FEMA is a learning and growing organization. This evolution from...management. FEMA is a better organization today than ever in their history but this improvement on the national level has come at the price of less

  5. Emergency management: Implementing a new strategy

    SciTech Connect

    Indelicato, G.

    1997-09-01

    Many of the problems resulting from a release incident stem from lack of preparation for such incidents; lack of control and coordination of the activities performed during the incident response; and mistaken assumptions regarding responsibility for the clean up. One unique approach to this type of situation addresses these and other issues thereby facilitating the primary objectives of cost control and incident closure. The Arrowhead Concept{reg_sign} to emergency response separates a release incident into two main phases: response phase and resolution phase. Each phase has three stages or activities. The response phase is the part of the incident that is typically performed under emergency conditions; it is urgent and fast-paced, with the need for a lot of decisions to be made without a lot of information. This phase is broken down into three concurrent activities: initial communication and coordination; release containment and control (abatement); and regulatory notification and negotiation.

  6. Appraisal of Scientific Resources for Emergency Management.

    DTIC Science & Technology

    1983-09-01

    CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE Office of Research, National Preparedness Program September 1983 Directorate, Federal Emergency...case alone. 10 The storm also brought on a rodent problem, Mr. Tobin said. He contacted the Center for Disease Control , who in turn sent officials to the...area and worked with local health officials to control the pests. Summary of Scientific Factors: Mr. Tobin reported that relatively little

  7. Emergency Management: A National Perspective. 1

    DTIC Science & Technology

    1989-06-01

    support. The one obvious exception was the Environmental Protection Agency (EPA) - created as a result of a great public groundswell and born and bred in...Hazard Reduction (1978) # 9 National Fire Prevention and Control # 7 Warning and Emergency Broadcast (t977) (Commerce)_______(1973) __ Same Devid Mcd...something of a small miracle that FEMA even survived, and that isn’t appreciated." In the face of great opposition to the very existence of the agency

  8. Texas Emergency Resource Management. Volume II.

    DTIC Science & Technology

    1979-09-30

    essential needs in Texas in a nuclear attack emergency or crisis relocation phase. Disaster Health and Medical Services: Medical and dental care for...Texas Medical Association (2) Texas Osteopathic Association (3) Texas Dental Association (4) Texas Veterinary Medical Association (5) Texas Nurses...50.07 Nurse, Professional 0-33 Dental Technician (Sub. Serv.) 0-50.06 Occupational Therapist 9-32.04 Dentist 0-13. Optometrist 0-39.92 Food and Drug

  9. Management of emerging multidrug-resistant tuberculosis in a low-prevalence setting.

    PubMed

    Catho, G; Couraud, S; Grard, S; Bouaziz, A; Sénéchal, A; Valour, F; Perpoint, T; Braun, E; Biron, F; Ferry, T; Chidiac, C; Freymond, N; Perrot, E; Souquet, P-J; Maury, J-M; Tronc, F; Veziris, N; Lina, G; Dumitrescu, O; Ader, F

    2015-05-01

    Multidrug-resistant (MDR) tuberculosis (TB) is an emerging concern in communities with a low TB prevalence and a high standard of public health. Twenty-three consecutive adult MDR TB patients who were treated at our institution between 2007 and 2013 were reviewed for demographic characteristics and anti-TB treatment management, which included surgical procedures and long-term patient follow-up. This report of our experience emphasizes the need for an individualized approach as MDR TB brings mycobacterial disease management to a higher level of expertise, and for a balance to be found between international current guidelines and patient-tailored treatment strategies. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  10. [Activity report on a rapid post-emergency consultation for the management of dermatological emergencies [corrected

    PubMed

    Ingen-Housz-Oro, S; Mirkamali, A; Valeyrie-Allanore, L; Chosidow, O; Wolkenstein, P

    2010-01-01

    Dermatological emergencies generally consist of infection and inflammation, including cutaneous drug reactions. Most patients are either not seen again or else are followed by their GP, but it may be a long time before they see a dermatologist once more, even if monitoring is necessary. We created a rapid post-emergency consultation reserved for these patients alone requiring short-term reevaluation, and we report the results of the new consultation herein. One consultation per week is exclusively for patients seen in dermatological emergency units requiring rapid reassessment (i.e. within two weeks) for follow-up or in cases of uncertainty in the diagnosis. Between June 2008 and June 2009, 40 consultations were carried out, with 370 patients being enrolled and 214 attending the consultation (40% absenteeism), i.e. 3% of emergency unit patients. The mean time from the emergency consultation was 9.2 days and the reasons for consultation were: 34% infectious dermatoses, 36% inflammatory dermatoses, 7.5% cutaneous drug reactions and 19% miscellaneous diagnosis, with 4.2% uncertainty about diagnosis. The outcome after the emergency consultation was favourable in 76% of cases (complete healing or improvement). A follow-up consultation was proposed in 41.5% of cases, with 77.5% of patients attending. While the creation of this consultation did not significantly reduce the number of patients returning to the emergency service, it was welcomed by all dermatologists in charge of such dermatological emergency services. This rapid post-emergency consultation forms a small part of the activities of the dermatological emergency unit but is positive in the view of the dermatologists in charge of emergency consultations since it means patients can be given appointments soon after initial treatment, thus avoiding the need to return to the emergency unit. The diseases seen at this unit are similar to those seen in the emergency unit. While absenteeism is considerable, this type of

  11. Infectious Diseases

    MedlinePlus

    Infectious diseases kill more people worldwide than any other single cause. Infectious diseases are caused by germs. Germs are tiny living ... live NIH: National Institute of Allergy and Infectious Diseases

  12. Architecture for a Generalized Emergency Management Software System

    SciTech Connect

    Hoza, Mark; Bower, John C.; Stoops, LaMar R.; Downing, Timothy R.; Carter, Richard J.; Millard, W. David

    2002-12-19

    The Federal Emergency Management Information System (FEMIS) was originally developed for the Chemical Stockpile Emergency Preparedness Program (CSEPP). It has evolved from a CSEPP-specific emergency management software system to a general-purpose system that supports multiple types of hazards. The latest step in the evolution is the adoption of a hazard analysis architecture that enables the incorporation of hazard models for each of the hazards such that the model is seamlessly incorporated into the FEMIS hazard analysis subsystem. This paper describes that new architecture.

  13. The Model State Emergency Health Powers Act: planning for and response to bioterrorism and naturally occurring infectious diseases.

    PubMed

    Gostin, Lawrence O; Sapsin, Jason W; Teret, Stephen P; Burris, Scott; Mair, Julie Samia; Hodge, James G; Vernick, Jon S

    2002-08-07

    The Center for Law and the Public's Health at Georgetown and Johns Hopkins Universities drafted the Model State Emergency Health Powers Act (MSEHPA or Model Act) at the request of the Centers for Disease Control and Prevention. The Model Act provides state actors with the powers they need to detect and contain bioterrorism or a naturally occurring disease outbreak. Legislative bills based on the MSEHPA have been introduced in 34 states. Problems of obsolescence, inconsistency, and inadequacy may render current state laws ineffective or even counterproductive. State laws often date back to the early 20th century and have been built up in layers over the years. They frequently predate the vast changes in the public health sciences and constitutional law. The Model Act is structured to reflect 5 basic public health functions to be facilitated by law: (1) preparedness, comprehensive planning for a public health emergency; (2) surveillance, measures to detect and track public health emergencies; (3) management of property, ensuring adequate availability of vaccines, pharmaceuticals, and hospitals, as well as providing power to abate hazards to the public's health; (4) protection of persons, powers to compel vaccination, testing, treatment, isolation, and quarantine when clearly necessary; and (5) communication, providing clear and authoritative information to the public. The Model Act also contains a modernized, extensive set of principles and requirements to safeguard personal rights. Law can be a tool to improve public health preparedness. A constitutional democracy must balance the common good with respect for personal dignity, toleration of groups, and adherence to principles of justice.

  14. Approaches to emergency management teaching at the master's level.

    PubMed

    Alexander, David

    2013-01-01

    Training and education enable emergency managers to deal with complex situations, create durable networks of people with appropriate expertise, and ensure that knowledge is utilized to improve resilience in the face of disaster risk. Although there is a discrete literature on emergency management training, few attempts have been made to create an overview that discusses the key issues and proposes a standardized approach. This article examines the nature of training and education in emergency and disaster management. It analyzes the composition and requirements of courses at the master's degree level, which is considered to be the most appropriate tier for in-depth instruction in this field. This article defines "training" and "education" in the context of emergency management courses. It reviews the developing profile of the emergency manager in the light of training requirements. This article examines the question of whether emergency management is a branch of management science or whether it is something distinct and separate. Attention is given to the composition of a core curriculum and to the most appropriate pedagogical forms of delivering it. The article reviews the arguments for and against standardization of the curriculum and describes some of the pedagogical methods for delivering courses. Briefly, it considers the impact on training and education of new pedagogic methods based on information technology. It is concluded that the master's level is particularly suited to emergency and crisis management education, as it enables students to complement the in-depth knowledge they acquired in their disciplinary first degrees with a broader synthetic approach at the postgraduate level. Some measures of standardization of course offerings are desirable, in favor of creating a core curriculum that will ensure that essential core knowledge is imparted. Education and training in this field should include problem-solving approaches that enable students to learn

  15. Emerging trends in management of propionic acidemia.

    PubMed

    Rafique, Muhammad

    2014-04-01

    To evaluate the therapeutic agents used during metabolic crises and in long-term management of patients with propionic acidemia (PA). The records of PA patients were retrospectively evaluated. The study group consisted of 30 patients with 141 admissions. During metabolic crises, hyperammonemia was found in 130 (92%) admissions and almost all patients were managed with normal saline, ≥ 10% dextrose, and restriction of protein intake. In 56 (40%) admissions, management was done in intensive care unit, 31 (22%) with mechanical ventilation, 10 (7%) with haemodialysis, 16 (11%) with vasopressor agents, and 12 (9%) with insulin. In the rescue procedure, L-carnitine was used in 135 (96%) patients, sodium bicarbonate in 116 (82%), sodium benzoate in 76 (54%), and metronidazole in 10 (7%), biotin in about one-quarter, L-arginine in one third, and antibiotics in three-quarter of the admissions. Blood/packed RBCs were used in 28 (20%) patients, platelets in 26 (18%), fresh frozen plasma in 8 (6%), and granulocyte-colony stimulating factors in 10 (7%) admissions. All patients were managed completely/partially with medical nutrition formula plus amino acid mixture, vitamins and minerals. For long-term management 24 (80%) patients were on L-carnitine, 22 (73%) on sodium benzoate, 6 (20%) on biotin, one half on alkaline therapy and 4 (13%) on regular metronidazole use. Almost all patients were on medical formula and regular follow-up. Aggressive and adequate management of acute metabolic crises with restriction of protein intake, stabilization of patient, reversal of catabolism, and removal of toxic metabolites are essential steps. Concerted efforts to ensure adequate nutrition, to minimize the risk of acute decompensation and additional therapeutic advances are imperative to improve the outcome of PA patients.

  16. Acute Chest Pain: Emergency Evaluation and Management

    PubMed Central

    Walker, David M. C.

    1982-01-01

    Since cardiovascular and pulmonary disorders have significant morbidity and mortality, triage of patients who complain of chest pain is paramount. The less sophisticated the triage system, the more important the protocol should be to have these patients evaluated immediately. History and physical are still the most important diagnostic tools; information should be gathered from all available sources. Advanced cardiac life support training is most useful. Eight diagnostic classifications are described, together with the distinctions of onset, duration, location, radiation, precipitating and relieving factors, character and associated symptoms. The protocol for initial management is outlined, emphasizing coincident management wherever possible. Imagesp2005-a PMID:21286539

  17. Management of acute pancreatitis in emergency.

    PubMed

    Ojetti, V; Migneco, A; Manno, A; Verbo, A; Rizzo, G; Gentiloni Silveri, N

    2005-01-01

    This review focuses on the medical and endoscopic approachs to patients with acute mild or severe pancreatitis. Acute pancreatitis is an acute inflammatory process of the pancreas whose the main determinant of the outcome is the extent of pancreatic necrosis. After the diagnosis, a severity assessment using scoring systems and early contrast enhanced Computed Tomography should be performed in all patients within 48 hours from the admission. All cases of severe acute pancreatitis should be managed initially in intensive care units with full systems support. Patients with gallstone pancreatitis should have definitive Endoscopic Retrograde Colangio-Pancreatography (ERCP) or surgical management of the gallstones.

  18. Updating and Maintaining School Emergency Management Plans. Helpful Hints for School Emergency Management. Volume 2, Issue 3, 2007

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. Developing and implementing comprehensive, multi-hazard emergency management plans is an ongoing process that must be consistently reinforced and strengthened. Opportunities for reviewing, strengthening and updating…

  19. A gap analysis of the United States death care sector to determine training and education needs pertaining to highly infectious disease mitigation and management.

    PubMed

    Le, Aurora B; Witter, Lesley; Herstein, Jocelyn J; Jelden, Katelyn C; Beam, Elizabeth L; Gibbs, Shawn G; Lowe, John J

    2017-09-01

    A United States industry-specific gap analysis survey of the death care sector-which comprises organizations and businesses affiliated with the funeral industry and the handling of human remains- was developed, the results analyzed, and training and education needs in relation to highly infectious disease mitigation and management were explored in an effort to identify where occupational health and safety can be enhanced in this worker population. Collaborating national death care organizations distributed the 47-question electronic survey. N = 424 surveys were initiated and results recorded. The survey collected death care sector-specific information pertaining to the comfortability and willingness to handle highly infectious remains; perceptions of readiness, current policies and procedures in place to address highly infectious diseases; current highly infectious disease training levels, available resources, and personal protective equipment. One-third of respondents have been trained on how to manage highly infectious remains. There was a discrepancy between Supervisor/Management and Employee/Worker perceptions on employees' willingness and comfortability to manage potentially highly infectious remains. More than 40% of respondents did not know the correct routes of transmission for viral hemorrhagic fevers. Results suggest death care workers could benefit from increasing up-to-date industry-specific training and education on highly infectious disease risk mitigation and management. Professional death care sector organizations are positioned to disseminate information, training, and best practices.

  20. Remote sensing data sharing platform for emergency management

    NASA Astrophysics Data System (ADS)

    Tu, Yong; Peng, Jie; Li, Qi; Dong, Cheng; Zhao, Hui

    2009-06-01

    A national emergency spatial data sharing platform approach is a useful and a practical way to promote the discovering and integration of various data sources from different agencies. In this paper, an emergency spatial data sharing architecture used to facilitate resource discovery in the emergency management is presented. At routine time without disasters, the metadata can be shared between organizations so that the appropriate data to be used can easily be discovered. Also, in the event of emergency, this platform can be used to execute the data production plan scheduled by specialists to collect original data from different agencies according to the government's command, so that data can be distributed to the headquarters. On the basis of the introduction of the remote sensing data application in the earthquake, this paper also addresses the data resources (original remote sensing data, metadata, and data product) in the platform, as well as three core issues, data order management, metadata management and data distribution.

  1. Developing Higher Education Programs in Emergency Management: Ghana's Experience

    ERIC Educational Resources Information Center

    Yakubu, Mariama Bisongu

    2013-01-01

    Ghana is highly vulnerable and threatened by several hazards and has sought ways of minimizing impacts of hazards events over time including demonstrating an interest in developing an emergency management training and an higher education degree program. Yet, as of 2013, the country has not developed a disaster management training program or a…

  2. Developing Higher Education Programs in Emergency Management: Ghana's Experience

    ERIC Educational Resources Information Center

    Yakubu, Mariama Bisongu

    2013-01-01

    Ghana is highly vulnerable and threatened by several hazards and has sought ways of minimizing impacts of hazards events over time including demonstrating an interest in developing an emergency management training and an higher education degree program. Yet, as of 2013, the country has not developed a disaster management training program or a…

  3. The Emerging Role of Women in Management: A Bibliography.

    ERIC Educational Resources Information Center

    Pask, Judith M., Comp.

    The role of women in management has become a topic of interest and importance during the last few years. This bibliography was compiled as a contribution to the Krannert Graduate School of Industrial Administration's seminar, The Emerging Role of Women in Management, held March 19, 1976. The materials included have been limited to those dealing…

  4. Emergency managers as change agents: recognizing the value of management, leadership, and strategic management in the disaster profession.

    PubMed

    Urby, Heriberto; McEntire, David A

    2015-01-01

    This article discusses the influence of management theory, some principles of leadership, four strategic management considerations, that are applied to emergency management, allow emergency managers to transform their followers, organizations, and communities at large. The authors argue that in the past there has been little recognition of the value, or application, of these three areas of emphasis in the disaster profession. Using more of these principles, emergency managers may transform into transformational change agents who make a difference in their followers' lives, who themselves transform other people and improve emergency management.

  5. Adaptive Management of Emerging Battlefield Network

    DTIC Science & Technology

    2004-03-01

    70 B. DESCRIPTION OF THE NEW ADAPTIVE MANEGEMENT PROTOCOL... safety , garbage collection, and platform independence.13 All the above approaches are based on mobile agents that act more or less isolated – there is...manner, assuming only raw management capabilities available. B. DESCRIPTION OF THE NEW ADAPTIVE MANEGEMENT PROTOCOL 1. Introduction The previous

  6. Emerging Environmental Management Curricula in Minnesota

    ERIC Educational Resources Information Center

    Naylon, Michael J.

    1971-01-01

    Defined is the need for implementation of programs intended to restore and/or maintain wildlife populations on a self-renewing, self-sustaining basis. Development of environmental management concepts, understandings, activities, and lesson ideas is explained accompanied by schematic drawings. (BL)

  7. Managing mastitis in the emergency department.

    PubMed

    Summers, Anthony

    2011-10-01

    Mastitis is a common clinical condition and, although not exclusive to lactating mothers, most patients with the condition seen by clinical staff fall into this group. Between 3 and 33 per cent of lactating mothers experience an episode of mastitis (Academy of Breastfeeding Medicine 2008, Jahanfar et al 2009). Most of these mothers receive treatment from their midwives or GPs, but some attend EDs and require treatment for, and education about, the condition from emergency care staff, including nurse practitioners (NPs). This article describes mastitis and the various treatment measures, and aims to improve NPs' ability and confidence in recognising and treating the condition.

  8. [Management of emergency cases, hospitalized in Romania in 2007].

    PubMed

    Tarcea, Monica; Zugravu, Corina; Szavuj, J; Finta, Hajnal; Patraulea, F; Szasz, F

    2009-01-01

    We evaluated the main aspects of the management of emergency cases, hospitalized in Romania in 2007, by following the frequency of main diagnosis, their distribution by place and hospital and hospital indicators. We collected our data from the Insurance Houses and National Institute of Statistics. Emergency cases represented in 2007 half of total cases hospitalized in Romania. Women are more frequent hospitalized then man or children. The Romanian South-East area had the highest frequency of emergency cases hospitalized. From all types of deceased cases, the emergency cases had the highest frequency. In emergency, the main category of diagnosis by frequency is "pregnancy, birth and recently given birth", much higher than non-emergency cases registered, also at the Obstretics-Gynecology and Emergency Hospitals. The medium period of days hospitalized for emergency cases was one week time. Most of the emergency cases are healed comparing to non-emergency ones. The main problem of hospitals in Romania is related to health services financing, costs for health care are still growing but also did the quality of health services and number of cases coming in emergency rooms.

  9. The Federal Emergency Management Agency's National Incident Management System

    EPA Pesticide Factsheets

    The NIMS provides an integrated framework defining the roles and responsibilities of federal, state and local first responders, developed with responders from different jurisdictions and disciplines, to better work together during emergency events.

  10. Management of infectious diseases in remote northwestern Ontario with telemedicine videoconference consultations.

    PubMed

    Mashru, Jai; Kirlew, Michael; Saginur, Raphael; Schreiber, Yoko S

    2017-01-01

    Northwestern Ontario in Canada provides a unique clinical challenge for providing optimal medical care. It is a large geographic area (385,000 km(2)) and is home to 32 remote First Nations communities, most without road access. These communities suffer a heavy burden of infectious disease and specialist consultations are difficult to obtain. The Division of Infectious Diseases at the Ottawa Hospital and the Sioux Lookout Meno Ya Win Health Centre established a telemedicine-based infectious disease consultation service in July 2014. We describe the implementation of this service, types of cases seen and patient satisfaction, as well as some of the challenges encountered. Information on visits was prospectively collected through an administrative database, and patient satisfaction surveys were administered after each initial consultation. During our first year of operation, 191 teleconsultations occurred: 76 initial consultations, 82 follow-up appointments and 33 case conferences. The scope of cases has been broad, mostly involving musculoskeletal infections (26%), followed by skin and soft tissue infections (23%). HCV, acute rheumatic fever, and respiratory infections (including pulmonary tuberculosis) were other diagnoses. Patient satisfaction has been very high and 28 telemedicine patient visits have occurred in their remote home communities, minimizing travel. The infectious disease consulting service and local clinicians have succeeded in addressing needs for care in infectious diseases in northwestern Ontario, where important gaps in service to First Nations' communities continue to exist. Regular scheduled available access to an infectious disease specialist is a well-received advancement of care in this remote region of Canada.

  11. 76 FR 63308 - Data and Data Needs To Advance Risk Assessment for Emerging Infectious Diseases Relevant to Blood...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ... Diseases Relevant to Blood and Blood Products; Public Workshop AGENCY: Food and Drug Administration, HHS... Blood and Blood Products.'' The purpose of the public workshop is to discuss data and data sources... infectious diseases (EIDs) that are relevant to blood and blood products and the benefits of...

  12. I consensus for the management and treatment of hepatitis B carried out by the Brazilian society of infectious diseases.

    PubMed

    Araújo, Evaldo Stanislau Affonso de; Barone, Antonio Alci; Junior, Fernando Lopes G; Ferreira, João Silva Mendonça Simão; Focaccia, Roberto

    2007-02-01

    This paper reports on the conclusions reached by the Hepatitis Committee of the Brazilian Society of Infectious Diseases in their I Consensus for the Management and Treatment of Hepatitis B. The subjects considered most relevant or controversial among those discussed by the Consensus Group, which met in the city of São Roque on July 21-23, 2006, are summarized in this report. A systematic review on topics related to hepatitis B was carried out and published in the Brazilian Journal of Infectious Diseases. We strongly recommend that readers consult the Proceedings of the Consensus Meeting in which a full, detailed report on the topics discussed is published, whereas in the Consensus, these topics are concisely and objectively summarized.

  13. Genetic Assignment Methods for Gaining Insight into the Management of Infectious Disease by Understanding Pathogen, Vector, and Host Movement

    PubMed Central

    Remais, Justin V.; Xiao, Ning; Akullian, Adam; Qiu, Dongchuan; Blair, David

    2011-01-01

    For many pathogens with environmental stages, or those carried by vectors or intermediate hosts, disease transmission is strongly influenced by pathogen, host, and vector movements across complex landscapes, and thus quantitative measures of movement rate and direction can reveal new opportunities for disease management and intervention. Genetic assignment methods are a set of powerful statistical approaches useful for establishing population membership of individuals. Recent theoretical improvements allow these techniques to be used to cost-effectively estimate the magnitude and direction of key movements in infectious disease systems, revealing important ecological and environmental features that facilitate or limit transmission. Here, we review the theory, statistical framework, and molecular markers that underlie assignment methods, and we critically examine recent applications of assignment tests in infectious disease epidemiology. Research directions that capitalize on use of the techniques are discussed, focusing on key parameters needing study for improved understanding of patterns of disease. PMID:21552326

  14. [Monitoring and management on the mandatory reporting system of infectious diseases in Jiangxi provincial].

    PubMed

    Tang, Y; Cheng, H

    1998-06-01

    From 1994 to 1997, we had continuously and actively conducted surveillance on reports of legal infectious diseases and administrative performance of hospitals in this aspect. The proportion from outpatient clinic in the whole province under supervision had sucessively increased yearly. It suggested that the implementation of "report on the first visit" regulation had been improved; the number of hospitals with "no information on epidemic desease" had decreased, and the number of months with no information on epidemic disease had also decreased. All the results showed that the surveillance and monitoring on the infectious desease reporting system and administrative performance of hospitals was an effective practice.

  15. Network Management in an Emergency Communications System.

    DTIC Science & Technology

    1986-03-01

    EhhohhohEohhEI ANEOEEhh * . * - - 11112 I. ROC".,. ’. 11111 IIIII+ m "I’ _.__ .+4 .... a ..• .. 7 .7 R.- ’- ’c -’ 00 NAVAN NAVAL POSTGRADUAIE SCHOOL 0...re uirements for a generic emerrceoc: jommuni cat ic _!i tem,a .vell as specul1aItion oIn po te nt ialI r e clu ir e m enIts " Ur f -I t11r a - r a...network monitoring tells management processors and personnel what is happe .:ning throughout the network, where problems are devel- oping, and what is the

  16. Industrial ecology: an emerging management science.

    PubMed Central

    Piasecki, B

    1992-01-01

    Pollution is a complex equation, compounded by population, rate of consumption, and toxic emissions per unit of resource consumed. This article defines industrial ecology as a management science that focuses a corporation's expertise on the third variable. Thus, industrial ecology is involved with changing the efficiency of machines, not just changing the law or a firm's compliance strategy. This article also explores how this emphasis allows a profoundly different orientation than the end-of-the-pipe regulatory approach of the last 20 yr. PMID:11607271

  17. [Treatment of emergencies in the hospital--problems and management].

    PubMed

    Sablotzki, A; Schubert, S; Kuhn, C; Radke, J; Czeslick, E

    2003-01-01

    Due to the growing number of high-risk patients, the increasing proportion of geriatric patients and the expansion of surgical and invasive-diagnostic procedures, medical stuff in hospitals are confronted with a rising number of emergency situations. Nearly 50% are of cardio-circulatory origin and occur during surgical interventions or immediately afterwards. Another cause of life-threatening complications are side-effects of orally or intravenously administered agents, especially after treatment with antibiotics, anaesthetics, analgetics and sedatives. Due to a lack of emergency training and management in most hospitals, the survival rate after cardiopulmonary resuscitation in general wards lies between just two and 35%. Thus it seems necessary to perform special training in CPR procedures and emergency management at regular intervals for the entire medical stuff. In addition, a special infrastructure for giving sufficient treatment in emergencies has to be established (emergency team, emergency telephone number, intra-hospital emergency car). The second part of this review presents current diagnostic and therapeutic strategies for the most common emergency situations, e.g. anaphylaxis, myocardial infarction, pulmonary embolism, gastrointestinal bleeding, and heparin-induced thrombocytopenia (HIT).

  18. Dodging a Bullet: WHO, SARS, and the Successful Management of Infectious Disease

    ERIC Educational Resources Information Center

    Michelson, Evan S.

    2005-01-01

    The purpose of this article is to analyze the policy decisions made by the World Health Organization (WHO) in working to fight the spread of the first truly global infectious disease, severe acute respiratory syndrome (SARS), of the 21st century. In particular, the author pays attention to the WHO's Global Outbreak Alert and Response Network…

  19. Waste Water Management and Infectious Disease. Part II: Impact of Waste Water Treatment

    ERIC Educational Resources Information Center

    Cooper, Robert C.

    1975-01-01

    The ability of various treatment processes, such as oxidation ponds, chemical coagulation and filtration, and the soil mantle, to remove the agents of infectious disease found in waste water is discussed. The literature concerning the efficiency of removal of these organisms by various treatment processes is reviewed. (BT)

  20. Waste Water Management and Infectious Disease. Part II: Impact of Waste Water Treatment

    ERIC Educational Resources Information Center

    Cooper, Robert C.

    1975-01-01

    The ability of various treatment processes, such as oxidation ponds, chemical coagulation and filtration, and the soil mantle, to remove the agents of infectious disease found in waste water is discussed. The literature concerning the efficiency of removal of these organisms by various treatment processes is reviewed. (BT)

  1. Dodging a Bullet: WHO, SARS, and the Successful Management of Infectious Disease

    ERIC Educational Resources Information Center

    Michelson, Evan S.

    2005-01-01

    The purpose of this article is to analyze the policy decisions made by the World Health Organization (WHO) in working to fight the spread of the first truly global infectious disease, severe acute respiratory syndrome (SARS), of the 21st century. In particular, the author pays attention to the WHO's Global Outbreak Alert and Response Network…

  2. Assessing hospital emergency management plans: a guide for infection preventionists.

    PubMed

    Rebmann, Terri

    2009-11-01

    Hospital emergency management plans are essential and must include input from an infection preventionist (IP). Multiple hospital planning documents exist, but many do not address infection prevention issues, combine them with noninfection prevention issues, or are disease/event specific. An all-encompassing emergency management planning guide for IPs is needed. A literature review and Internet search were conducted in December 2008. Data from relevant sources were extracted. A spreadsheet was created that delineated hospital emergency management plan components of interest to IPs. Of the sources screened, 49 were deemed relevant. Eleven domains were identified: (1) having a plan; (2) assessing hospital readiness; (3) having infection prevention policies and procedures; (4) having occupational health policies and procedures; (5) conducting surveillance and triage; (6) reporting incidents, having a communication plan, and managing information; (7) having laboratory support; (8) addressing surge capacity issues; (9) having anti-infective therapy and/or vaccines; (10) providing infection prevention education; and (11) managing physical plant issues. Infection preventionists should use this article as an assessment tool for evaluating their hospital emergency management plan and for developing policies and procedures that will decrease the risk of infection transmission during a mass casualty event.

  3. Emergency Department Management of Patients With Febrile Neutropenia: Guideline Concordant or Overly Aggressive?

    PubMed

    Baugh, Christopher W; Wang, Thomas J; Caterino, Jeffrey M; Baker, Olesya N; Brooks, Gabriel A; Reust, Audrey C; Pallin, Daniel J

    2017-01-01

    The Infectious Diseases Society of America and the American Society of Clinical Oncology recommend risk stratification of patients with febrile neutropenia (FN) and discharge with oral antibiotics for low-risk patients. We studied guideline concordance and clinical outcomes of FN management in our emergency department (ED). Our urban, tertiary care teaching hospital provides all emergency and inpatient services to a large comprehensive cancer center. We performed a structured chart review of all FN patients seen in our ED from January 2010 to December 2014. Using electronic medical records, we identified all visits by patients with fever and an absolute neutrophil count of <1000 cells/mm(3) and then included only patients without a clear source of infection. Following national guidelines, we classified patients as low or high risk and assessed guideline concordance in disposition and parenteral versus oral antibiotic therapy by risk category as our main outcome measure. Of 173 qualifying visits, we classified 44 (25%) as low risk and 129 (75%) as high risk. Management was guideline concordant in 121 (70%, 95% confidence interval [CI] = 63% to 77%). Management was guideline discordant in 43 (98%, 95% CI = 88% to 100%) of low-risk patients versus 9 (7%, 95% CI = 3% to 13%) of high-risk patients (relative risk [RR] = 14, 95% CI = 7.5 to 26). Of 52 guideline-discordant cases, 36 (83%, 95% CI = 72% to 93%) involved low-risk cases with treatment that was more aggressive than recommended. Guideline concordance was low among low-risk patients, with management tending to be more aggressive than recommended. Unless data emerge that undermine the guidelines, we believe that many of these hospitalizations and parenteral antibiotic regimens can be avoided, decreasing the risks associated with hospitalization, while improving antibiotic stewardship and patient comfort. © 2016 by the Society for Academic Emergency Medicine.

  4. Evolving Prehospital, Emergency Department, and “Inpatient” Management Models for Geriatric Emergencies

    PubMed Central

    Carpenter, Christopher R.; Platts-Mills, Timothy F.

    2013-01-01

    Alternative management methods are essential to ensure high quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols for case-finding and rapid diagnosis to support early condition-specific treatment for older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to look beyond the diagnosis to address the influence of other factors on the patient's health: isolation and depression; finances and transportation; and chronic medical conditions and polypharmacy. This review article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care. PMID:23177599

  5. Emergency department management of seizures in pediatric patients.

    PubMed

    Santillanes, Genevieve; Luc, Quyen

    2015-03-01

    Seizures account for 1% of all emergency department visits for children, and the etiologies range from benign to life-threatening. The challenge for emergency clinicians is to diagnose and treat the life-threatening causes of seizures while avoiding unnecessary radiation exposure and painful procedures in patients who are unlikely to have an emergent pathology. When treating patients in status epilepticus, emergency clinicians are also faced with the challenge of choosing anticonvulsant medications that will be efficacious while minimizing harmful side effects. Unfortunately, evidence to guide the evaluation and management of children presenting with new and breakthrough seizures and status epilepticus is limited. This review summarizes available evidence and guidelines on the diagnostic evaluation of first-time, breakthrough, and simple and complex febrile seizures. Management of seizures in neonates and seizures due to toxic ingestions is also reviewed.

  6. Some considerations for mass casualty management in radiation emergencies.

    PubMed

    Hopmeier, Michael; Abrahams, Jonathan; Carr, Zhanat

    2010-06-01

    Radiation emergencies are rather new to humankind, as compared to other types of emergencies such as earthquakes, floods, or hurricanes. Fortunately, they are rare, but because of that, planning for response to large-scale radiation emergencies is least understood. Along with the specific technical aspects of response to radiation emergencies, there are some general guiding principles of responding to mass casualty events of any nature, as identified by the World Health Organization in its 2007 manual for mass casualty management systems. The paper brings forward such general considerations as applicable to radiation mass casualty events, including (1) clear lines of communication; (2) scalability of approach; (3) whole-of-health approach; (4) knowledge based approach; and (5) multisectoral approach. Additionally, some key considerations of planning for mass casualty management systems are discussed, namely, health systems surge capacity and networking, risk and resources mapping, and others.

  7. A Framework for Modeling Emerging Diseases to Inform Management

    PubMed Central

    Katz, Rachel A.; Richgels, Katherine L.D.; Walsh, Daniel P.; Grant, Evan H.C.

    2017-01-01

    The rapid emergence and reemergence of zoonotic diseases requires the ability to rapidly evaluate and implement optimal management decisions. Actions to control or mitigate the effects of emerging pathogens are commonly delayed because of uncertainty in the estimates and the predicted outcomes of the control tactics. The development of models that describe the best-known information regarding the disease system at the early stages of disease emergence is an essential step for optimal decision-making. Models can predict the potential effects of the pathogen, provide guidance for assessing the likelihood of success of different proposed management actions, quantify the uncertainty surrounding the choice of the optimal decision, and highlight critical areas for immediate research. We demonstrate how to develop models that can be used as a part of a decision-making framework to determine the likelihood of success of different management actions given current knowledge. PMID:27983501

  8. A framework for modeling emerging diseases to inform management

    USGS Publications Warehouse

    Russell, Robin E.; Katz, Rachel A.; Richgels, Katherine L.D.; Walsh, Daniel P.; Grant, Evan

    2017-01-01

    The rapid emergence and reemergence of zoonotic diseases requires the ability to rapidly evaluate and implement optimal management decisions. Actions to control or mitigate the effects of emerging pathogens are commonly delayed because of uncertainty in the estimates and the predicted outcomes of the control tactics. The development of models that describe the best-known information regarding the disease system at the early stages of disease emergence is an essential step for optimal decision-making. Models can predict the potential effects of the pathogen, provide guidance for assessing the likelihood of success of different proposed management actions, quantify the uncertainty surrounding the choice of the optimal decision, and highlight critical areas for immediate research. We demonstrate how to develop models that can be used as a part of a decision-making framework to determine the likelihood of success of different management actions given current knowledge.

  9. The Profession of Emergency Management: Educational Opportunities and Gaps

    DTIC Science & Technology

    2008-01-01

    courses on fire technology and/or safety and the area of Hazardous Materials were excluded from further analysis. Degrees and courses offered by...one percent of schools had a Bachelor’s degree related to Emergency Management. One hundred and seventy-eight schools (18.83%) had courses on Fire ... Technology and/or Fire Safety. Just over sixteen percent of schools offered courses on Hazardous Material disposal, emergencies, and/or clean-up. The

  10. Controlling Infectious Diseases in Nurseries

    Treesearch

    T. H. Filer

    1968-01-01

    At least 300 publications have been written about non-infectious and infectious diseases of tree seedlings. I will outline some of the progress that is being made in finding ways to control infectious diseases, those caused by pathogens. I will touch upon pre- and post-emergence damping-off, root rots, leaf spots, and fusiform rust, which are the most serious diseases...

  11. Business continuity management in emerging markets: the case of Jordan.

    PubMed

    Sawalha, Ihab H; Anchor, John R

    2012-01-01

    Despite their considerable growth in last few decades, emerging markets (EM) face numerous risks that have the potential to slow down or obstruct their development. Three main issues are discussed in this paper: first, the risks facing organisations operating in emerging markets and Jordan in particular; secondly, the role of business continuity management (BCM) in emerging markets; and thirdly, potential factors that underpin the role of BCM in emerging markets. These issues are significant, as they represent the role of BCM in highly dynamic and fast changing business environments. The paper provides a discussion of the significance of BCM in reducing or preventing risks facing organisations operating in emerging markets, especially those in Jordan.

  12. A Risk Management Architecture for Emergency Integrated Aircraft Control

    NASA Technical Reports Server (NTRS)

    McGlynn, Gregory E.; Litt, Jonathan S.; Lemon, Kimberly A.; Csank, Jeffrey T.

    2011-01-01

    Enhanced engine operation--operation that is beyond normal limits--has the potential to improve the adaptability and safety of aircraft in emergency situations. Intelligent use of enhanced engine operation to improve the handling qualities of the aircraft requires sophisticated risk estimation techniques and a risk management system that spans the flight and propulsion controllers. In this paper, an architecture that weighs the risks of the emergency and of possible engine performance enhancements to reduce overall risk to the aircraft is described. Two examples of emergency situations are presented to demonstrate the interaction between the flight and propulsion controllers to facilitate the enhanced operation.

  13. Upping The Emergency Management Ante: The Role Of Private Sector Collaboration In Emergency Management And Whether State Procurement And Emergency Management Laws Are Built To Collaborate

    DTIC Science & Technology

    2016-03-01

    the states have in place policies that augment state law, those policies would have to agree with the state standard proposed. But, local laws were...emergency management statutory frameworks in place to make greater public-private collaborations a reality . But, some states and many of their...Partnerships for Meeting Regional Threats.” New Realities : Law Enforcement in the Post-9/11 Era. NCJ 210679, United States Department of Justice, Office of

  14. Management of cluster headache in the Emergency Department.

    PubMed

    Di Sabato, Francesco; Giacovazzo, Mario

    2005-09-01

    Although cluster headache (CH) is considered one of the most distinctive and painful primary headache disorders in clinical practice because of the brevity of each attack, its management is not always ergonomic or possible in the Emergency Department. In case of a previously competent diagnosis, the Emergency Department's team should send the patient to a headache centre where specialists in the management of CH can handle the pathology in the best way. In our headache centre we treat patients with CH attacks with a hyperbaric chamber, confirming the effectiveness of hyperbaric oxygen in CH patients.

  15. Precision Information Environments Envisioning the future of emergency management

    SciTech Connect

    2010-04-01

    Researchers at Pacific Northwest National Laboratory are developing future work environments for the emergency management community called Precision Information Environments (or PIEs). PIEs will provide tailored access to information and decision support capabilities in a system that supports the multiple user roles, contexts, and phases of emergency management, planning, and response. This video gives you a look at one vision for the future. To view an annotated version that describes each of the technology concepts you'll see as well as the end user needs that motivated them and the research challenges that must be addressed to make them a reality visit http://precisioninformation.org.

  16. Review article: Crisis resource management in emergency medicine.

    PubMed

    Carne, Belinda; Kennedy, Marcus; Gray, Tim

    2012-02-01

    Effective team management is a core element of expert practice in emergency medicine. Thus far, training in emergency medicine has focussed predominantly on proficiency in medical and technical skills, with emergency physicians acquiring these 'non-technical' skills in an ad hoc manner or by trial and error with varying levels of success. This paper describes a set of behaviours that, when practised in conjunction with medical and technical expertise, can reduce the incidence of clinical error and contribute to effective teamwork and the smooth running of an ED. Teaching and practice of these behaviours is now a core element of training and skills maintenance in other high-risk areas, such as aviation, and is becoming part of the routine training for anaesthetists. They address areas, such as communication, leadership, knowledge of environment, anticipation and planning, obtaining timely assistance, attention allocation and workload distribution. We outline the application of these behaviours in the speciality of emergency medicine, and suggest that the teaching and practice of crisis resource management principles should become part of the curriculum for training and credentialing of emergency medicine specialists. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  17. Handling Emergency Management in [an] Object Oriented Modeling Environment

    NASA Technical Reports Server (NTRS)

    Tokgoz, Berna Eren; Cakir, Volkan; Gheorghe, Adrian V.

    2010-01-01

    It has been understood that protection of a nation from extreme disasters is a challenging task. Impacts of extreme disasters on a nation's critical infrastructures, economy and society could be devastating. A protection plan itself would not be sufficient when a disaster strikes. Hence, there is a need for a holistic approach to establish more resilient infrastructures to withstand extreme disasters. A resilient infrastructure can be defined as a system or facility that is able to withstand damage, but if affected, can be readily and cost-effectively restored. The key issue to establish resilient infrastructures is to incorporate existing protection plans with comprehensive preparedness actions to respond, recover and restore as quickly as possible, and to minimize extreme disaster impacts. Although national organizations will respond to a disaster, extreme disasters need to be handled mostly by local emergency management departments. Since emergency management departments have to deal with complex systems, they have to have a manageable plan and efficient organizational structures to coordinate all these systems. A strong organizational structure is the key in responding fast before and during disasters, and recovering quickly after disasters. In this study, the entire emergency management is viewed as an enterprise and modelled through enterprise management approach. Managing an enterprise or a large complex system is a very challenging task. It is critical for an enterprise to respond to challenges in a timely manner with quick decision making. This study addresses the problem of handling emergency management at regional level in an object oriented modelling environment developed by use of TopEase software. Emergency Operation Plan of the City of Hampton, Virginia, has been incorporated into TopEase for analysis. The methodology used in this study has been supported by a case study on critical infrastructure resiliency in Hampton Roads.

  18. epiPATH: an information system for the storage and management of molecular epidemiology data from infectious pathogens

    PubMed Central

    Amadoz, Alicia; González-Candelas, Fernando

    2007-01-01

    Background Most research scientists working in the fields of molecular epidemiology, population and evolutionary genetics are confronted with the management of large volumes of data. Moreover, the data used in studies of infectious diseases are complex and usually derive from different institutions such as hospitals or laboratories. Since no public database scheme incorporating clinical and epidemiological information about patients and molecular information about pathogens is currently available, we have developed an information system, composed by a main database and a web-based interface, which integrates both types of data and satisfies requirements of good organization, simple accessibility, data security and multi-user support. Results From the moment a patient arrives to a hospital or health centre until the processing and analysis of molecular sequences obtained from infectious pathogens in the laboratory, lots of information is collected from different sources. We have divided the most relevant data into 12 conceptual modules around which we have organized the database schema. Our schema is very complete and it covers many aspects of sample sources, samples, laboratory processes, molecular sequences, phylogenetics results, clinical tests and results, clinical information, treatments, pathogens, transmissions, outbreaks and bibliographic information. Communication between end-users and the selected Relational Database Management System (RDMS) is carried out by default through a command-line window or through a user-friendly, web-based interface which provides access and management tools for the data. Conclusion epiPATH is an information system for managing clinical and molecular information from infectious diseases. It facilitates daily work related to infectious pathogens and sequences obtained from them. This software is intended for local installation in order to safeguard private data and provides advanced SQL-users the flexibility to adapt it to their

  19. Managing aggression in the emergency department: promoting an interdisciplinary approach.

    PubMed

    Rintoul, Yvonne; Wynaden, Dianne; McGowan, Sunita

    2009-04-01

    Incidents of aggression are frequent occurrences in hospitals, particularly the emergency department. Aggression creates instability in the environment, impacts on patient care outcomes and leads to increased levels of stress in staff. Regular exposure to aggression in the workplace can have detrimental effects on health professionals' ongoing quality of life. The emergency department is a gateway to care and is heavily populated 24h a day. Therefore, it is essential that all health professionals are confident and well prepared to manage aggression. Based upon a review of the literature this paper outlines the causes of aggression and provides an interdisciplinary action plan for intervening with aggressive patients in the emergency department. The importance of interdisciplinary ownership and the well planned management of aggression are outlined. When well managed, the impact of aggression can be limited. Stability in the emergency department ensures that health professionals can be responsive to the community's needs for emergency care. This leads to the provision of effective and timely care and a stable work environment for all health professionals.

  20. Airway emergencies presenting to the paediatric emergency department requiring advanced management techniques.

    PubMed

    Simma, Leopold; Cincotta, Domenic; Sabato, Stefan; Long, Elliot

    2017-09-01

    Airway emergencies presenting to the emergency department (ED) are usually managed with conventional equipment and techniques. The patient group managed urgently in the operating room (OR) has not been described. This study aims to describe a case series of children presenting to the ED with airway emergencies managed urgently in the OR, particularly the anaesthetic equipment and techniques used and airway findings. A retrospective cohort study undertaken at The Royal Children's Hospital, Melbourne, Australia. All patients presenting to the ED between 1 January 2012 and 30 July 2015 (42 months) with an airway emergency who were subsequently managed in the OR were included. Patient characteristics, anaesthetic equipment and technique and airway findings were recorded. Twenty-two airway emergencies in 21 patients were included over the study period, on average one every 2 months. Median age was 18 months and 43% were male. Inhalational induction was used in 77.3%, combined inhalational and intravenous induction in 9.1%, and intravenous induction alone in 13.6%. The most commonly used inhalational induction agent was sevoflurane, and the most commonly used intravenous induction agents were ketamine and propofol. Ten airway emergencies did not require intubation, seven for removal of inhaled foreign body, two with progressive tracheal stenosis requiring emergent dilatation and one examination under anaesthesia to rule out inhaled foreign body. Of the 12 airway emergencies that required immediate intubation, direct laryngoscopy was used in 9 and fibre-optic intubating bronchoscopy in 3. For intubations performed by direct laryngoscopy, one was difficult (Cormack and Lehane grade 3). First pass success was 83.3%. Adverse events occurred in 3/22 (13.6%) cases. Advanced airway techniques, including inhalational induction and intubation via fibre-optic intubating bronchoscope, are rarely but predictably required in the management of patients presenting to the ED

  1. Emergency management and homeland security: Exploring the relationship.

    PubMed

    Kahan, Jerome H

    2015-01-01

    In the years after the 9/11 tragedy, the United States continues to face risks from all forms of major disasters, from potentially dangerous terrorist attacks to catastrophic acts of nature. Professionals in the fields of emergency management and homeland security have responsibilities for ensuring that all levels of government, urban areas and communities, nongovernmental organizations, businesses, and individual citizens are prepared to deal with such hazards though actions that reduce risks to lives and property. Regrettably, the overall efficiency and effectiveness of the nation's ability to deal with disasters is unnecessarily challenged by the absence of a common understanding on how these fields are related in the workforce and educational arenas. Complicating matters further is the fact that neither of these fields has developed agreed definitions. In many ways, homeland security and emergency management have come to represent two different worlds and cultures. These conditions can have a deleterious effect on preparedness planning for public and private stakeholders across the nation when coordinated responses among federal, state, and local activities are essential for dealing with consequential hazards. This article demonstrates that the fields of emergency management and homeland security share many responsibilities but are not identical in scope or skills. It argues that emergency management should be considered a critical subset of the far broader and more strategic field of homeland security. From analytically based conclusions, it recommends five steps that be taken to bring these fields closer together to benefit more from their synergist relationship as well as from their individual contributions.

  2. EMERGING TECHNOLOGIES FOR THE MANAGEMENT AND UTILIZATION OF LANDFILL GAS

    EPA Science Inventory

    The report gives information on emerging technologies that are considered to be commercially available (Tier 1), currently undergoing research and development (Tier 2), or considered as potentially applicable (Tier 3) for the management of landfill gas (LFG) emissions or for the ...

  3. Teachers' knowledge of emergency management of traumatised teeth in preschools.

    PubMed

    Nemutandani, M S; Yengopal, V; Rudolph, M J

    2011-02-01

    Dental trauma remains one of the major oral health problems in childhood and is the cause of much pain and distress. It may occur as a result of a sports mishap, an altercation or a fall while playing inside the school premises. Prompt and appropriate management of traumatised teeth is essential for a good prognosis of an injured tooth. The aim of the study was to assess teachers' knowledge of emergency management of traumatized teeth in early childhood developmental centres (ECDCs). A cross sectional self-administered questionnaire was used to collect data among teachers in ECDCs in Hillbrow and Berea suburbs, Johannesburg, South Africa. Almost all respondents (98.1%) were female; 59.6% were between 20 and 29 years of age. Almost a quarter of the centres were not registered and 39.1% of the school teachers were not formally qualified as ECDCs teachers. A small percentage (11.5%) received dental emergency training as a part of their school health education programs. Knowledge of ECDCs teachers on the emergency management of traumatized teeth appeared inadequate; in the event of emergency dental trauma, substantial number of teachers would not be able to respond appropriately. All teachers should have training on basic management of dental trauma.

  4. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents

    ERIC Educational Resources Information Center

    Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy

    2013-01-01

    Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…

  5. Emergency Management Instruction. Instructor's Guide for Grades 7-9.

    ERIC Educational Resources Information Center

    North Carolina State Div. of Emergency Management, Raleigh.

    Emergency Management education seeks to give students basic information about natural and man-made disasters, preparedness procedures, and survival techniques. The intent of this guide is to aid teachers in presenting disaster survival instruction in the junior high school grades. The materials are designed to supplement existing curricula, where…

  6. Healthcare logistics in disaster planning and emergency management: A perspective.

    PubMed

    VanVactor, Jerry D

    2017-12-01

    This paper discusses the role of healthcare supply chain management in disaster mitigation and management. While there is an abundance of literature examining emergency management and disaster preparedness efforts across an array of industries, little information has been directed specifically toward the emergency interface, interoperability and unconventional relationships among civilian institutions and the US Department of Defense (US DoD) or supply chain operations involved therein. To address this imbalance, this paper provides US DoD healthcare supply chain managers with concepts related to communicating and planning more effectively. It is worth remembering, however, that all disasters are local - under the auspice of tiered response involving federal agencies, the principal responsibility for responding to domestic disasters and emergencies rests with the lowest level of government equipped and able to deal with the incident effectively. As such, the findings are equally applicable to institutions outside the military. It also bears repeating that every crisis is unique: there is no such thing as a uniform response for every incident. The role of the US DoD in emergency preparedness and disaster planning is changing and will continue to do so as the need for roles in support of a larger effort also continues to change.

  7. Seeking Accountability through State-Appointed Emergency District Management

    ERIC Educational Resources Information Center

    Arsen, David; Mason, Mary L.

    2013-01-01

    Michigan's Local Government and School District Accountability Act of 2011 empowers the governor to appoint emergency managers (EMs) in financially troubled school districts. EMs assume all powers of the superintendent and school board. They can reshape academic programs, nullify labor contracts, and open and close schools. This article analyzes…

  8. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents

    ERIC Educational Resources Information Center

    Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy

    2013-01-01

    Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…

  9. EMERGING TECHNOLOGIES FOR THE MANAGEMENT AND UTILIZATION OF LANDFILL GAS

    EPA Science Inventory

    The report gives information on emerging technologies that are considered to be commercially available (Tier 1), currently undergoing research and development (Tier 2), or considered as potentially applicable (Tier 3) for the management of landfill gas (LFG) emissions or for the ...

  10. Seeking Accountability through State-Appointed Emergency District Management

    ERIC Educational Resources Information Center

    Arsen, David; Mason, Mary L.

    2013-01-01

    Michigan's Local Government and School District Accountability Act of 2011 empowers the governor to appoint emergency managers (EMs) in financially troubled school districts. EMs assume all powers of the superintendent and school board. They can reshape academic programs, nullify labor contracts, and open and close schools. This article analyzes…

  11. Privacy Impact Assessment for the Emergency Management Portal

    EPA Pesticide Factsheets

    The Emergency Management Portal System collects cleanup site data, and personnel readiness data. Learn how this data will be collected in the system, how it will be used, access to the data, the purpose of data collection, and record retention policies.

  12. Infant Trauma Management in the Emergency Department: An Emergency Medicine Simulation Exercise

    PubMed Central

    Mathieson, Sarah; Whalen, Desmond

    2015-01-01

    In a trauma situation, it is essential that emergency room physicians are able to think clearly, make decisions quickly and manage patients in a way consistent with their injuries. In order for emergency medicine residents to adequately develop the skills to deal with trauma situations, it is imperative that they have the opportunity to experience such scenarios in a controlled environment with aptly timed feedback. In the case of infant trauma, sensitivities have to be taken that are specific to pediatric medicine. The following describes a simulation session in which trainees were tasked with managing an infantile patient who had experienced a major trauma as a result of a single vehicle accident. The described simulation session utilized human patient simulators and was tailored to junior (year 1 and 2) emergency medicine residents. PMID:26487992

  13. [Critical incidents in preclinical emergency airway management : Evaluation of the CIRS emergency medicine databank].

    PubMed

    Hohenstein, C; Schultheis, K; Winning, J; Rupp, P; Fleischmann, T

    2013-09-01

    Many patients are victims of disastrous incidents during medical interventions. One of the obligations of physicians is to identify these incidents and to subsequently develop preventive strategies in order to prevent future events. Airway management and prehospital emergency medicine are of particular interest as both categories frequently show very dynamic developments. Incidents in this particular area can lead to serious injury but at the same time it has never been analyzed what kind of incidents might harm patients during prehospital airway management. The German website http://www.cirs-notfallmedizin.de (CIRS critical incident reporting systems) offers anonymous reporting of critical incidents in prehospital emergency medicine. All incidents reported between 2005 and 2012 were screened to identify those which were concerned with airway management and four experts in this field analyzed the incidents and performed a root cause analysis. The database contained 845 reports. The authors considered 144 reports to be airway management related and identified 10 root causes: indications for intubation but no intubation performed (n = 8), no indications for intubation but intubation attempt performed (n = 7), wrong medication (n = 25), insufficient practical skills (n = 46), no use of alternative airway management (n = 7), insufficient handling before or after intubation (n = 27), defect equipment (n = 28), lack of equipment (n = 31), others (n = 18) and factors that cannot be influenced (n = 12). The incidents that were reported via the website http://www.cirs-notfallmedizin.de and that occurred during airway management in prehospital emergency medicine are described. To improve practical airway management skills of emergency physicians are one of the most important tasks in order to prevent critical incidents and are discussed in the article.

  14. Optimising the management of pulmonary arterial hypertension patients: emergency treatments.

    PubMed

    Delcroix, M; Naeije, R

    2010-09-01

    Pulmonary arterial hypertension (PAH) is a rare and potentially fatal disease whose management is usually restricted to a few specialised centres. As patients do not necessarily live in the neighbourhood of these centres, daily care and emergencies have to be delegated to first and second lines. Treatment guidelines do not usually provide recommendations for acute emergency situations as evidence is scarce. This short review provides a description of our therapeutic protocols based on available data. A model of transmural organisation of care for PAH patients, currently applied in Belgium, is described. Thereafter, based on an analysis of the reasons of death in the PAH population, a review of the main emergencies is provided. Cardiac arrest and resuscitation, decompensated right heart failure, respiratory failure, arrhythmia, pericardial effusion, haemoptysis, surgery and drug-related adverse events will be discussed successively. Case reports showing the precariousness of PAH patients will enforce our thesis of the need for optimal patient management organisation.

  15. The application of supply chain management principles to emergency management logistics: An empirical study.

    PubMed

    Peterson, Matthew R; Young, Richard R; Gordon, Gary A

    2016-01-01

    Key elements of supply chain theory remain relevant to emergency management (EM) logistics activities. The Supply Chain Operations Reference model can also serve as a useful template for the planning, organizing, and execution of EM logistics. Through a series of case studies (developed through intensive survey of organizations and individuals responsible for EM), the authors identified the extent supply chain theory is being adopted and whether the theory was useful for emergency logistics managers. The authors found several drivers that influence the likelihood of an organization to implement elements of supply chain management: the frequency of events, organizational resources, population density, range of events, and severity of the disaster or emergency.

  16. Improving the safety of remote site emergency airway management

    PubMed Central

    Wijesuriya, Julian; Brand, Jonathan

    2014-01-01

    Airway management, particularly in non-theatre settings, is an area of anaesthesia and critical care associated with significant risk of morbidity & mortality, as highlighted during the 4th National Audit Project of the Royal College of Anaesthetists (NAP4). A survey of junior anaesthetists at our hospital highlighted a lack of confidence and perceived lack of safety in emergency airway management, especially in non-theatre settings. We developed and implemented a multifaceted airway package designed to improve the safety of remote site airway management. A Rapid Sequence Induction (RSI) checklist was developed; this was combined with new advanced airway equipment and drugs bags. Additionally, new carbon dioxide detector filters were procured in order to comply with NAP4 monitoring recommendations. The RSI checklists were placed in key locations throughout the hospital and the drugs and advanced airway equipment bags were centralised in the Intensive Care Unit (ICU). It was agreed with the senior nursing staff that an appropriately trained ICU nurse would attend all emergency situations with new airway resources upon request. Departmental guidelines were updated to include details of the new resources and the on-call anaesthetist's responsibilities regarding checks and maintenance. Following our intervention trainees reported higher confidence levels regarding remote site emergency airway management. Nine trusts within the Northern Region were surveyed and we found large variations in the provision of remote site airway management resources. Complications in remote site airway management due lack of available appropriate drugs, equipment or trained staff are potentially life threatening and completely avoidable. Utilising the intervention package an anaesthetist would be able to safely plan and prepare for airway management in any setting. They would subsequently have the drugs, equipment, and trained assistance required to manage any difficulties or complications

  17. Improving the safety of remote site emergency airway management.

    PubMed

    Wijesuriya, Julian; Brand, Jonathan

    2014-01-01

    Airway management, particularly in non-theatre settings, is an area of anaesthesia and critical care associated with significant risk of morbidity & mortality, as highlighted during the 4th National Audit Project of the Royal College of Anaesthetists (NAP4). A survey of junior anaesthetists at our hospital highlighted a lack of confidence and perceived lack of safety in emergency airway management, especially in non-theatre settings. We developed and implemented a multifaceted airway package designed to improve the safety of remote site airway management. A Rapid Sequence Induction (RSI) checklist was developed; this was combined with new advanced airway equipment and drugs bags. Additionally, new carbon dioxide detector filters were procured in order to comply with NAP4 monitoring recommendations. The RSI checklists were placed in key locations throughout the hospital and the drugs and advanced airway equipment bags were centralised in the Intensive Care Unit (ICU). It was agreed with the senior nursing staff that an appropriately trained ICU nurse would attend all emergency situations with new airway resources upon request. Departmental guidelines were updated to include details of the new resources and the on-call anaesthetist's responsibilities regarding checks and maintenance. Following our intervention trainees reported higher confidence levels regarding remote site emergency airway management. Nine trusts within the Northern Region were surveyed and we found large variations in the provision of remote site airway management resources. Complications in remote site airway management due lack of available appropriate drugs, equipment or trained staff are potentially life threatening and completely avoidable. Utilising the intervention package an anaesthetist would be able to safely plan and prepare for airway management in any setting. They would subsequently have the drugs, equipment, and trained assistance required to manage any difficulties or complications

  18. EMERGING INFECTIOUS DISEASE AGENTS AND ISSUES ASSOCIATED WITH THE MANAGEMENT OF TREATED SLUDGES (BIOSOLIDS)

    EPA Science Inventory

    This presentation looks at the pathogenic microorganisms present in municipal sludges and the public's concerns with the land application of sludges/biosolids. Methods for reducing pathogens in sludge; methods for reducing the vector attractiveness of sludge; and issues associate...

  19. A Multi Agent Based Approach for Prehospital Emergency Management.

    PubMed

    Safdari, Reza; Shoshtarian Malak, Jaleh; Mohammadzadeh, Niloofar; Danesh Shahraki, Azimeh

    2017-07-01

    To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed. The proposed architecture was simulated using Anylogic simulation software. Anylogic Agent Model, State Chart and Process Model were used to model the system. Multi agent systems (MAS) had a great success in distributed, complex and dynamic problem solving environments, and utilizing autonomous agents provides intelligent decision making capabilities.  The proposed architecture presents prehospital management operations. The main identified agents are: EMS Center, Ambulance, Traffic Station, Healthcare Provider, Patient, Consultation Center, National Medical Record System and quality of service monitoring agent. In a critical condition like prehospital emergency we are coping with sophisticated processes like ambulance navigation health care provider and service assignment, consultation, recalling patients past medical history through a centralized EHR system and monitoring healthcare quality in a real-time manner. The main advantage of our work has been the multi agent system utilization. Our Future work will include proposed architecture implementation and evaluation of its impact on patient quality care improvement.

  20. Evidence into practice: emergency physician management of common pediatric fractures.

    PubMed

    Boutis, Kathy; Howard, Andrew; Constantine, Erika; Cuomo, Anna; Narayanan, Unni

    2014-07-01

    Randomized trials have shown that removable immobilization devices are at least as good as circumferential casts for the management of common specific types of pediatric wrist and ankle fractures. Our main objective was to determine the proportion of emergency physicians who prescribe removable devices for distal radius buckle fractures and/or nondisplaced distal fibular Salter-Harris I fractures. We also examined follow-up referral patterns for these injuries. This was an online survey of members of 2 national emergency physician associations in Canada: Pediatric Emergency Research Canada and the Canadian Association of Emergency Physicians. Of the 849 eligible participants, 447 responded to the survey, yielding an aggregate response rate of 52.7%. Organization-specific response rates were 169 (70.4%) of 240 for the Pediatric Emergency Research Canada and 278 (45.6%) of 609 for the Canadian Association of Emergency Physicians. Overall, 263 of 416 (63.2%; 95% confidence interval [CI], 58.6-67.8) of emergency physicians treat buckle fractures of the distal radius with a removable splint and refer 212 of 398 (53.3%; 95% CI, 48.4-58.2) of these injuries to the primary care physician for follow-up. For Salter-Harris I fractures of the distal fibula, emergency physicians treat 201 of 416 (48.3%; 95% CI, 43.5-53.1) with a removable ankle support and refer 94 of 398 (23.6%; 95% CI, 19.4-27.8) to the primary care physician for follow-up. At least 50% of the surveyed Canadian emergency physicians treat distal radius buckle fractures and/or Salter-Harris I fibular fractures with a removable immobilization device, and the primary care physician follow-up of these injuries occur with some regularity for both these injuries.