infectious disease: prevention strategies & emergency ... · infectious disease: ... “total...

Taipei City Government1

Yen-Jen Sung, MD, PhDCommissioner

Department of HealthTaipei City Government

Infectious Disease: Prevention Strategies &

Emergency Response Procedures


Taipei City SARS Epidemic of 2003 1The first case of SARS in Taiwan-Area:A China-based Taiwanese businessman, Mr. Chin, and his wife reported March 14, 2003, the first immigrated & local cases

April 24, 2004: Heping Hospital Sealed for Isolation

March-August, 2003: 1539 cases reported by hospitals & clinics in metro Taipei; 157 Taipei residents

June 17, 2003, Taiwan removed from WHO’s travel alert list

July 15, 2003, Taiwan removed from Epidemic Region list


Residential quarantine

26,942 grade A quarantined persons

(direct contact with potential SARS patients)

13,358 grade B quarantined persons

(returning from epidemic regions)

Of all quarantined, 12 (≈ 0.030%) diagnosed as

potential or suspected SARS cases

Taipei City SARS Epidemic of 2003 2


Preparedness to Counter SARS 11. Organization Overhaul

Division for Disease Control and PreventionDisease Control & Prevention BranchInfectious Disease Specialized (Heping) Branch & Research Center

2. Nosocomial Infection ControlFever screening stations for all incoming patientsTraining and education of hospital staffNosocomial infection preventionLife-saving equipment inventory system for tracking and distribution “Total care” nursing system: family members discouraged to stay

3. Surveillance & ReportingReporting/Sharing of notifiable disease surveillance dataMobile community-based infectious disease prevention teamsIntegrated disease control measures with CDC of central government


Preparedness to Counter SARS 24. Emergency Response System

Integrated infectious disease information system

Emergency Operation Center (EOC )

Incident Command System (ICS)

Disease Prevention Consulting Committee (DPCC)

5. Health Education2004 Asia-Pacific Anti-bioterrorism Symposium -

380 participants including medical professionals, hospital administrators, college personnel, fire service, police, professional and general public

“General medicine” (PGY1) training course for all resident physicians


Taipei City GovernmentTaipei City Government

Food and Drug DivisionFood and Drug Division

Medical Affairs DivisionMedical Affairs Division

Health Promotion DivisionHealth Promotion Division

Research and Planning DivisionResearch and Planning Division

System Administration OfficeSystem Administration Office

Statistics OfficeStatistics Office

Administrative ServicesAdministrative Services

Accounting OfficeAccounting Office

Personnel OfficePersonnel Office

Government Ethics OfficeGovernment Ethics Office

Zhongxing BranchZhongxing Branch

Renai BranchRenai Branch

Heping BranchHeping BranchYangming BranchYangming Branch

Zhongxiao BranchZhongxiao Branch

Chinese Medicine BranchChinese Medicine Branch

Songde BranchSongde Branch

Taipei Municipal Guandu Hospital Taipei Municipal Guandu Hospital Taipei Municipal Wanfang HospitalTaipei Municipal Wanfang Hospital

Department of HealthDepartment of Health

Disease Control and Prevention Division

Disease Control and Prevention Division

LaboratoryLaboratory

Disease Control and Prevention Branch

Disease Control and Prevention Branch

12 District Health Centers12 District Health Centers

Taipei City HospitalTaipei City Hospital

Women and Children BranchWomen and Children Branch


Annual “Total Security” Drill (萬安演習)300 held hostage by 6 armed BIOterrorists from …

August 24, 2005

Taipei City Emergency Response System


1. Avian influenza as a legally defined infectious disease: Dec. 29, 2004.

National security level of alert announced last month.

2. Epidemic Watch:

(1) Body temperature monitor for poultry/livestock/pet bird business

workers

(2) Human avian influenza infections and reporting

3. Joint Prevention Task Force supported by different agencies:

TCG Joint Prevention Task Force for Avian Flu

Assistance & consultation for poultry/livestock/pet business workers

Close monitor for all incidents of avian flu

4. Isolation, hospitalization, and treatment resource integration

New & Emerging Infectious Diseases1


Avian Flu Prevention & Control Drills

Legend:Department of Health receives reports from animal inspection division of chickens possibly carrying avian influenza virus …

Staff dispatched to the scene pack euthanized chickens into plastic bags. Workers are evacuated from danger zones and sprayed thoroughly with disinfectant solution by the cleaning staff (esp. armpit, groin and feet)




Joint Prevention Task Force for Bird Flu: Experts in Health, Animal Inspection & Education Departments provide assistance, education and consultation specifically to Zoos, Nature Parks, Poultry/Pet Businesses

Staff from Departments of Economic Development and Environment Protection visiting Guandu Nature Park for disease prevention education programs

Staff from Departments of Economic Development and Health were visiting Pet Bird/Poultry vendors for disease prevention education


School Reporting System2,065 cases reported by child care facilities (pioneering model first established in Taipei)

Hospital Reporting SystemEmergency Care facilities reported 5,172

cases; 397 Taipei City residents

13 complicated with severe symptoms--7 excluded enteroviral infection--6 confirmed

(as of June 30, 2005)

School campus-reported enterovirus cases

Emergency care -reported enterovirus cases

Enterovirus Epidemic 1

58115124127127132143153159165171175193210238261291

357

990

1382

1697

1959

2065

693

486

94

106

262

03

315

9

392

36

21

58

5 11 10 6 6 6 4 18 17 28 2330 66

129

207

297

0

300

600

900

1200

1500

1800

2100

0

50

100

150

200

250

300

350

400

450

500

Accumulative (Left Axis)

Weekly (Right Axis)

A c c umul a t i ve (L e f t A x i s ) 58 94 115 124 127 127 132 143 153 159 165 171 175 193 210 238 261 291 357 486 693 99 0 138 169 195 206

We e kl y (Ri ght A xi s ) 58 36 21 9 3 0 5 11 10 6 6 6 4 18 17 28 23 30 66 129 207 297 392 315 262 106

1. 1 1. 2 1 . 3 1 . 4 2. 1 2. 2 2. 3 2. 4 3. 1 3. 2 3 . 3 3 . 4 4. 1 4. 2 4. 3 4. 4 4. 5 5. 1 5 . 2 5 . 3 5. 4 6. 1 6. 2 6. 3 6. 4 6. 5

月週

5,172

239118 345419

526480 564 604 638 691 742

4,748

4,113

3,488

2,751

2,1281,647

1,3311,1681,062969903830785

118 121

46 38 40 3453 51 43 45

73 6693 106

163

623

737

635

424481

61

316

106

74

625

0500

100015002000250030003500400045005000

01002003004005006007008009001000

Accumulative (Left Axis)

Weekly (Right Axis)

Accumulative (Left Axis) 118 239 345 419 480 526 564 604 638 691 742 785 830 903 969 1062 1168 1331 1647 2128 2751 3488 4113 4748 5172

Weekly (Right Axis) 118 121 106 74 61 46 38 40 34 53 51 43 45 73 66 93 106 163 316 481 623 737 625 635 424

1.1 1.2 1.3 1.4 2.1 2.2 2.3 2.4 3.1 3.2 3.3 3.4 4.1 4.2 4.3 4.4 5.1 5.2 5.3 5.4 6.1 6.2 6.3 6.4 6.5月週


Strategies• Enhanced Health Education

• Advocate frequent hand washing and equipment cleaning (wet, rub, rinse, hold, wipe)

• Improve inter-agency cooperation

• Improve epidemic surveillance systems

• Establish bilingual reporting system

Enterovirus Epidemic2


Taipei City Notifiable Disease Statistics Total Case of 2004 (ND Defined by Law)

TAIWAN TaipeiTuberculosis 10523 903HIV Infection 1570 210Scarlet Fever 759 130Dengue Fever 420 12AIDS 260 41Bacillary Dysentery 146 22Legionnaire's Disease 105 18Enterovirus (severe case)associated symptoms 49 4Typhoid 37 7Encephalitis B. 32 0Amoebic Dysentery 31 10Pertussis 21 3Influenza (servere case) 19 4Malaria 18 5Dengue Hemorrhagic Fever 7 0


Future Efforts for for Disease Prevention

1. Professional mobile disease prevention teams

2. Efficiency of infectious disease reporting

3. Occurrence prevention & mortality reduction

4. Nosocomial infection prevention

5. Effective community surveillance & reporting

6. Efficient investigation of reported cases

7. International collaboration


Welcome to TaipeiWelcome to Taipei

infectious disease: prevention strategies & emergency ... · infectious disease: ... “total...

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