UNCLASSIFIED

Pandemic Influenza and Regional Emerging Diseases

Strengthening the National Bio-Surveillance System

Douglas SearlesLT, MSC, USNChief, Technical Services and Quality Assurance, Certifying ScientistForensic Toxicology Division, Armed Forces Institute of Pathology

Current National Situation National Plan

◦ Working with neighbors Strengthening the National plan

Multiple Surveillance Systems◦ Centers for Disease Control and Prevention (CDC

National Electronic Disease Surveillance System (NEDSS) Nation Wide Health Information Network (NHIN)

◦ United States Army Center for Health Promotion and Preventive Medicine (USACHPPM)

◦ Navy and Marine Corps Public Health Center (NMCPC) Medical Events Reporting Systems (NDRSi)

◦ Department of Defense - Global Emerging Infections Surveillance and Response System (DOD-GEIS) Electronic Surveillance System for the Early Notification of

Community-based Epidemics (ESSENCE)

United States Army Center for Health Promotion and Preventive Medicine(USACHPPM)

Department of Defense - Global Emerging Infections Surveillance and Response System (DOD-GEIS)

Armed Forces Health Surveillance Center (AFHSC)

United States of America Canada Mexico

A Pandemic Threatens All Without Regard to Borders

Controlling the spread with minimal economic disruption

Detect, contain and control an AI outbreak and prevent transmission to humans

Prevent or slow the entry of a novel strain of human influenza to North America

Minimize illness and deaths Sustain infrastructure and mitigate the impact

to the economy and the functioning of society◦ Influenza will not physically damage critical

infrastructure, systems may be weakened by the absence of essential personnel in the workplace or the diversion of resources.

Plan should extend beyond the health and medical sectors to include provisions in relation to critical infrastructure and the movement of goods and services across borders.

International Partnership on Avian and Pandemic Influenza

Standards and guidelines of the World Organization for Animal Health (OIE)

World Health Organization (WHO) International Health Regulations (IHRs) Rules and provisions of the World Trade

Organization (WTO) North American Free Trade Agreement (NAFTA) United Nations Food and Agriculture Organization

(FAO)United Nations (UN) System Influenza Coordinator

Novel A/H1N1 Experience◦ Lessons learned

Detection◦ Complicated by incorrect models, noisy baselines, and

misdiagnosis Identification

◦ Rapid dissemination of screening/laboratory methods Communication

◦ “Critical” data changes as epidemics progress Surveillance

◦ Vital that there are in place good surveillance systems able to return data promptly

Why are reemerging infections becoming a serious public health concern?

Growing human population increases the demand for nutritional support, resulting in intensive agricultural practices.

This involves enormous numbers of animals, or multiple species farmed within the same region.

Update warning processes

Procedural pathways for risk communication◦ Use of current technologies◦ Practice, practice, practice

Establish public health liaisons (local, national, international)

Boarder monitoring and control measures◦ Land crossings - aviation - marine◦ Determine best practices for in-flight management

of ill travelers (likely to develop on longer flights)◦ Border control with minimal commerce disruption

and maximal protection

Vigilance Practice Reassessment COMMUNICATION

CDC http://www.cdc.gov USACHPPM http://chppm-www.apgea.army.mil DoD-GEIS http://afhsc.mil NMCPHC http://www-nehc.med.navy.mil WHO http://www.who.int CDHAM http://www.cdham.org US Dept of Health and Human Services

http://www.hhs.gov

LT Douglas Searles◦ Email: douglas.searles@afip.osd.mil