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MEXICO BEFORE ANINFLUENZA PANDEMIC
BOGOTÁ, COLOMBIAAPRIL, 2006
THE NEXT INFLUENZA PANDEMIC:A RESPONSE BY THE MEXICAN STATE
Dr. Yessica Chaparro
REGIONAL MEETING ABOUT THE PREPAREDNESS AND RESPONSE OF THE HEALTH ATTENTION SERVICES TO AN INFLUENZA PANDEMIC
MEXICO BEFORE ANINFLUENZA PANDEMIC
• Created in 2003
• Analysis definition,
coordination, monitoring and
evaluation of policies,
strategies and actions in
terms of Health Safety.
National Committee for Health SafetyNational Committee for Health Safety
Protect the health of the population from risks and damages originated by epidemiological emergencies and disasters
MEXICO BEFORE ANINFLUENZA PANDEMIC
Strategic ComponentsStrategic Components
Flooding, hurricanes, earthquakes, volcanic eruptions, fires...
Intoxication with chemical substances, explosions, toxic substance spills, environmental contamination...
Intentional liberation of biological agents.…
Contamination, overpopulation, risks to patients or personnel….
Dengue, VON, malaria,
leptospirosis, influenza, ETAS, SARS...
MEXICO BEFORE ANINFLUENZA PANDEMIC
OBJECTIVEOBJECTIVE
To protect the Mexican population from the To protect the Mexican population from the risk of an influenza pandemic through the risk of an influenza pandemic through the coordination of actions that allow the coordination of actions that allow the preparation of a rapid responsepreparation of a rapid response
National Plan for Preparation and Response to an Influenza Pandemic
Dynamic document under permanent evolution
Created by the Created by the National Committee for National Committee for Health SafetyHealth Safety
Second version currently under revision
MEXICO BEFORE ANINFLUENZA PANDEMIC
PHASES PRE PANDEMIC PANDEMIC ALERT PANDEMIC1 2 3 4 5 6OMS
There are no new subtypesof the Influenzavirus in humanbeings
New subtypeof the virus inanimals withconsiderablerisk of humandisease
Cases of disease inhumans witha new subtypeof the viruswithouttransmissionfrom human to human
Smalloutbreaks ofthe disease.Transmissionlimited fromperson to person
Largeoutbreaks ofthe disease.Transmissionlimited fromperson toperson
Transmissionsustained by thedisease
PRE PANDEMIC PANDEMICMEXICO
Preparation activities at a National Level
Cases in Asia
Cases in twoContinents
exceptAmerica
Cases inAmerica
Cases inMexico
Stages of Stages of AlertAlert
National Plan for the Preparation and Response to an Influenza Pandemic
1
2 3 4 5
MEXICO BEFORE ANINFLUENZA PANDEMIC
•Dissemination and social Dissemination and social mobilizationmobilization
•CoordinationCoordination
•Epidemiological vigilanceEpidemiological vigilance
•Medical AttentionMedical Attention
•Strategic reserveStrategic reserve
•Investigation and DevelopmentInvestigation and Development
National Plan for the Preparation and Response to an Influenza Pandemic
Lines of Lines of
ActionAction
MEXICO BEFORE ANINFLUENZA PANDEMIC
Dissemination and Social MobilizationDissemination and Social Mobilization
• Risk Communication StrategyRisk Communication Strategy
• Media Campaign in PhasesMedia Campaign in Phases
• Dissemination to the Population and Health ProfessionalsDissemination to the Population and Health Professionals
• Sensibilization of Strategic Groups (Teachers, Parents, Unions, Sensibilization of Strategic Groups (Teachers, Parents, Unions, Businesspeople etc.)Businesspeople etc.)
• Training of Strategic Personnel (Armed Forces and Public Order, Training of Strategic Personnel (Armed Forces and Public Order, Airports, Ports, Borders, Tourism)Airports, Ports, Borders, Tourism)
Information on the Internet:Information on the Internet:
www.salud.gob.mxwww.salud.gob.mx
Telephone: Telephone: 0180001800
MEXICO BEFORE ANINFLUENZA PANDEMIC
CoordinationCoordination
• Fundamental for a timely responseFundamental for a timely response
• Incorporation of all relevant areas through the National Incorporation of all relevant areas through the National Committee for Health SafetyCommittee for Health Safety
•Health SectorHealth Sector
• Inter sectorInter sector•State and Local LevelsState and Local Levels•InternationalInternational
International
FederalLevel
StateLevel
LocalLevel
FederalCommand
SESARed Cross
SEGOB SEDENA SEMAR SHCP SFP SEDESOL STPS SE SEP SCT SALUD SAGARPA SEMARNAT SRE SSP SECTUR
MEXICO BEFORE ANINFLUENZA PANDEMIC
CoordinationCoordination
FEDERAL LEVEL
CIVIL SOCIETYHEALTH SECTOROTHER SECTORS
STATE LEVEL
CIVIL SOCIETYHEALTH SECTOROTHER SECTORS
LOCAL LEVEL
CIVIL SOCIETYHEALTH UNITSOPERATIONAL AREAS
MEXICO BEFORE ANINFLUENZA PANDEMIC
CoordinationCoordination•InternationalInternational
• Ministry Reunion, Ottawa, Oct 2005Ministry Reunion, Ottawa, Oct 2005
• World Reunion on the Bird Flu and Pandemic, Geneva, Nov 2005World Reunion on the Bird Flu and Pandemic, Geneva, Nov 2005
• 6th. Ministerial Reunion of the Global Group on Health Safety 6th. Ministerial Reunion of the Global Group on Health Safety (G7+México), Rome, Nov. 2005(G7+México), Rome, Nov. 2005
• IPAPI Reunion, Washington, D.C., 2005IPAPI Reunion, Washington, D.C., 2005
• Workshop for Molding the Impact, San José, Costa Rica, 2005Workshop for Molding the Impact, San José, Costa Rica, 2005
• Sub regional Workshop for Preparing for an Influenza Pandemic, Sub regional Workshop for Preparing for an Influenza Pandemic, Panama, February 2006Panama, February 2006
MEXICO BEFORE ANINFLUENZA PANDEMIC
Epidemiological VigilanceEpidemiological Vigilance
• Training of Health Training of Health PersonnelPersonnel
• Strengthening RoutineStrengthening RoutineVigilanceVigilance
• Continuous Monitoring (UIES)Continuous Monitoring (UIES)
• Animal Vigilance (SAGARPA)Animal Vigilance (SAGARPA)
• Diagnostic CapacityDiagnostic Capacity
•Consolidation of the National Network of LaboratoriesConsolidation of the National Network of Laboratories
• Strengthening Laboratories P3Strengthening Laboratories P3
• International AgreementsInternational Agreements
MEXICO BEFORE ANINFLUENZA PANDEMIC
Preventive ActionsPreventive Actions
• Reduction of Social ContactReduction of Social Contact• Limit the movement of People and MerchandiseLimit the movement of People and Merchandise• Basic Hygiene measures (Washing hands, using masks)Basic Hygiene measures (Washing hands, using masks)
Main strategies for Pandemic control (Public Health Measures):Main strategies for Pandemic control (Public Health Measures):
• Triage schemeTriage scheme• Strengthening hospital attention capacityStrengthening hospital attention capacity• Protection measures for health personnelProtection measures for health personnel• Attention Protocols (Children and Adults)Attention Protocols (Children and Adults)• Management of RPBI/corpsesManagement of RPBI/corpses
Medical AttentionMedical Attention
Servicio médico forenseFallecido a consecuencia de un cuadro clínico sospechoso o confirmado de Influenza.
Compensación de enfermedad
crónica y complicaciones.
Unidad médica hospitalaria
fija o de campaña
Cuadro clínico de Influenza con complicaciones pulmonares y/o enfermedad crónica descompensada.
Sintomático y antivirales
Centro de Atención y
Aislamiento
Cuadro clínico de Influenza sin complicaciones pulmonares y/o enfermedad crónica controlada.
Sintomático y medidas de
bioseguridad
Aislamiento domiciliario
estricto
Sintomatología sugestiva de influenza, sin complicaciones pulmonares y sin enfermedad crónica agregada.
Sintomático y medidas de bioseguridad
DomicilioSintomatología respiratoria no compatible con influenza.
Medidas de bioseguridad
DomicilioSano, sin sintomatología respiratoria.
TratamientoReferenciaTipo de paciente
• Identification of the bird influenza stumps that are circlingIdentification of the bird influenza stumps that are circling• Permanent bird vaccination campaignsPermanent bird vaccination campaigns• Bird influenza outbreak control in farmsBird influenza outbreak control in farms
Strategies to control outbreaks in birds:Strategies to control outbreaks in birds:
MEXICO BEFORE ANINFLUENZA PANDEMIC
Hospital AttentionHospital Attention
Servicio médico forenseFallecido a consecuencia de un cuadro clínico sospechoso o confirmado de Influenza.
Compensación de enfermedad
crónica y complicaciones.
Unidad médica hospitalaria
fija o de campaña
Cuadro clínico de Influenza con complicaciones pulmonares y/o enfermedad crónica descompensada.
Sintomático y antivirales
Centro de Atención y
Aislamiento
Cuadro clínico de Influenza sin complicaciones pulmonares y/o enfermedad crónica controlada.
Sintomático y medidas de
bioseguridad
Aislamiento domiciliario
estricto
Sintomatología sugestiva de influenza, sin complicaciones pulmonares y sin enfermedad crónica agregada.
Sintomático y medidas de bioseguridad
DomicilioSintomatología respiratoria no compatible con influenza.
Medidas de bioseguridad
DomicilioSano, sin sintomatología respiratoria.
TratamientoReferenciaTipo de paciente
“Hospital Reconversion”
MINICLINIC
MINICLINIC
SECURITYPERIMETER
MEXICO BEFORE ANINFLUENZA PANDEMIC
Strategic ReservesStrategic Reserves
• Reserve for the initial response:Reserve for the initial response:
• Antiviral (Oseltamivir)Antiviral (Oseltamivir)• Post contact prophylaxis, treatmentPost contact prophylaxis, treatment• Priority schemePriority scheme
•Antibiotics for managing complicationsAntibiotics for managing complications•Protection equipment for health personnelProtection equipment for health personnel•Laboratory equipmentLaboratory equipment•Training materialTraining material• Vaccine against H5N1Vaccine against H5N1
• Investment requirements in States and MunicipalitiesInvestment requirements in States and Municipalities• Consideration of administrative aspectsConsideration of administrative aspects
MEXICO BEFORE ANINFLUENZA PANDEMIC
Anti Influenza VaccineAnti Influenza Vaccine
Vaccine against seasonal influenza in humansVaccine against seasonal influenza in humans Development of a prevention cultureDevelopment of a prevention culture Avoid genetic exchange between bird and Avoid genetic exchange between bird and human human virusesviruses
Establishment of international agreements to transfer technology Establishment of international agreements to transfer technology and training to personnel in Mexicoand training to personnel in Mexico
1St STAGE
VACCINE AGAINST
SEASONAL INFLUENZA
2nd STAGE
VACCINE AGAINST THE INFLUENZA PANDEMIC
VACCINE AGAINST
BIRD INFLUENZA
A (H5N1)
MEXICO BEFORE ANINFLUENZA PANDEMIC
• Need to increase basic investigation, clinical and Need to increase basic investigation, clinical and epidemiological, for the development of technologies and epidemiological, for the development of technologies and national capacity in terms of:national capacity in terms of:
Investigation and DevelopmentInvestigation and Development
• AntiviralAntiviral• New techniques for the production of vaccinesNew techniques for the production of vaccines• Alternative treatmentsAlternative treatments• Mathematical modeling for simulating scenariosMathematical modeling for simulating scenarios
Participation of Higher Education Institutions
MEXICO BEFORE ANINFLUENZA PANDEMIC
Steps to FollowSteps to Follow
• National simulation in a real scale and command post National simulation in a real scale and command post exercise in the second semester of 2006exercise in the second semester of 2006
“Escudo Centinela” ExerciseNational Exercise to evaluate the Response
capacity before an Influenza Pandemic
MEXICO BEFORE ANINFLUENZA PANDEMIC
Steps to FollowSteps to Follow
• Plan operation at a state and local levelPlan operation at a state and local level
• New version of PNPRPI: First Semester 2006New version of PNPRPI: First Semester 2006
• Evaluation exercises at all levelsEvaluation exercises at all levels
• Coordination with Central America and the CaribbeanCoordination with Central America and the Caribbean
• Media campaign designed in phasesMedia campaign designed in phases
MEXICO BEFORE ANINFLUENZA PANDEMIC
APRIL, 2006
THE NEXT INFLUENZA PANDEMIC: A RESPONSE by
THE MEXICAN STATE
www.dgepi.salud.gob.mx
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