SARS: SARS: International CoordinationInternational Coordination

and Collaboration and Collaboration

James W. LeDuc, Ph.D.James W. LeDuc, Ph.D.

Director, Division of Viral and Rickettsial Diseases Director, Division of Viral and Rickettsial Diseases

National Center for Infectious DiseasesNational Center for Infectious DiseasesCenters for Disease Control and PreventionCenters for Disease Control and Prevention

COORDINATION of response and resources

COLLABORATION in science

COMMUNICATION with global community

CAPACITY building and response preparedness

CHALLENGES and lessons learned

International SARS Response

COORDINATION of response and resources

COLLABORATION in science

COMMUNICATION with global community

CAPACITY building and response preparedness

CHALLENGES and lessons learned

International SARS Response

CDC SARS Investigation 2003

NCID

DVRD

Infectious Disease Pathology Activity

Respiratory and Enteric Viruses Branch

Special Pathogens Branch

NCID EOC Liaison

Field Teams

Response Teams

CDC

OD/OTPER/EOC OD/OC/ECS

China Taiwan

Canada

Hong Kong

Thailand Vietnam

Clinical and Infection Control

Global Migration and Quarantine

LaboratoryEpidemiology

Information Technology

Communications

International / WHO Occupational Health

Team “B”

Community Outreach

May 1, 2003

Team “P”

Environmental

Domestic Singapore

Special Investigations

84 personnel 1959 days ( = 7.8 work-years)

totals:

92 deployments * 

2Laos

151Cambodia

334Switzerland

604Thailand

886Hong Kong

98The Philippines

1039Canada

1375Singapore

22610Vietnam

49817China

69630Taiwan

total days# staff deployedCountry

* 6 staff members deployed to 2 or more countries

5

CDC International Response: Personnel

4

CDC International Response: Expertise

Med/Epi 52 Taiwan (17), China (12), Vietnam (8), HK (4), Canada (4), PI (3), Singapore (2), Switzerland (2), Thailand (2), Cambodia (1), Laos (1)

Path/Lab 8 China (5), Singapore (2), Taiwan (1), Vietnam (1)

Infxn Control 7 Taiwan (5), HK (1), PI (1), Vietnam (1)

Ind Hyg 7 Taiwan (4), Canada (3)

IT/Data 2 HK (1), Singapore (1)

PHA 4 Taiwan (3), Thailand (2), Laos (1)

Media 2 Canada (2)

Consultant 2 Switzerland (2)

84 personnel

COORDINATION of response and resources

COLLABORATION in science

COMMUNICATION with global community

CAPACITY building and response preparedness

CHALLENGES and lessons learned

International SARS Response

WHO: - Global network of 11 leading laboratories,secure website, conference calls

- Coordination of specimen acquisition

- Facilitate rapid identification of causative agent, development of diagnostic tests

CDC: - Specimen transport and processing

- >3000 int’l specimens processed from 27 countries

- Key role in virus isolation, characterization and diagnostic test development and deployment

Global SARS Response: Laboratory

CDC SARS Response: Reagents

CDC shipments of SARS diagnostic materials to national and international academic centers, commercial companies, and governmental agencies

RNA Virus Antigen

Academic 32 13 1 46

Commercial 26 15 1 42

Governmental 21 18 4 43

79 46 6 131

International Recipients of SARS diagnostic materials

CDC SARS Response: Lab Capacity

COORDINATION of response and resources

COLLABORATION in science

COMMUNICATION with global community

CAPACITY building and response preparedness

CHALLENGES and lessons learned

International SARS Response

Global SARS Response: Communications

WHO: - Secure GOARN website- WHO SARS website with daily updates- WHO global conference calls- CDC-DHHS-WHO video conferences

CDC: - Public Response Hotline (phone calls, emails, clinician hotline)- Daily response team briefings and regularly scheduled conference calls- SARS satellite broadcasts- SARS page on CDC website

CDC SARS Response: CommunicationsNews media calls handled: 10,166News releases issued: 12Live telebriefings/news conferences: 21Health care responder conference calls: 30

Public Response Hotline:34,229 phone calls answered3,557 emails answered2,017 physician hotline calls answered

3 SARS satellite broadcasts: >1.9 million participantsCDC SARS website: 17 million page views

(3.8 million for April 20-26)

COORDINATION of response and resources

COLLABORATION in science

COMMUNICATION with global community

CAPACITY building and response preparedness

CHALLENGES and lessons learned

International SARS Response

•Surveillance and reporting

•Diagnosis

• Infection control

•Travel advisories and health alerts

•Exposure management in health-care settings, the workplace, and schools

•Biosafety, environmental sampling, clean up

•Specimen handling, collection, and shipment

• Information for U.S. citizens living abroad and for international adoptions

CDC SARS Response: Outbreak Preparedness Guidance

http://www.cdc.gov/ncidod/sars/

COORDINATION of response and resources

COLLABORATION in science

COMMUNICATION with global community

CAPACITY building and response preparedness

CHALLENGES and lessons learned

International SARS Response

Global SARS Response: LessonsResources: Magnitude of response need and financial burden; shortage of available skilled responders; critical contribution of in-place personnel, epi/surv networks, local/national partnerships

Laboratory: Logistics of specimen collection, transport, processing; technical challenges around new pathogen

Communications: Need for accurate, consistent, timely information in a rapidly changing environment

Capacity building: Need for well validated diagnostics; training; infection control expertise

Politics: WHO/CDC response to Taiwan; coordinating role of WHO; importance of existing networks and partnerships