epidemic preparedness
TRANSCRIPT
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Epidemic preparedness&
Outbreak Investigation
State Institute of Health & Family Welfare, Jaipur
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Epidemic- Occurrence of diseases casesin community clearly in excess to thenormal expectation(measured asendemic level)
Outbreak-Used interchangeably withEpidemic but applies to-
Diseases with sudden onset
Short incubation period
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Why do Outbreaks Occur?
Single lapse in infection control in hosp.Lapse in surveillanceA hidden pocket of infectionSmuggled animalsSingle volume of international air trafficRapid mutation & Adaptation in microbial
worldEmergence of New risk groups
Modes of transmission can changeDrug resistance effect on treatment and
prophylaxis
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Outbreak management.involves
AnticipatingPreventing
Preparing
DetectingResponding
Controlling disease outbreaks with thewhole purpose of preventing or
minimizing health and economicimpacts of possible outbreaks
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Why Preparedness in Advance?
Emergencies caused by epidemics arefrequent
Epidemics require urgent action and
Epidemics may often lead to panic ifpreparedness is not adequate
Response can be delayed, with possibility of
fast spread, and avoidable loss to humanlives, and economy
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Why Investigate?
Control and prevention measures
Knowledge of an agent
Training
Public concerns
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Concepts in Outbreak Investigation
Quantifying the epidemic(Descriptive epidemiology)
Getting at the source (Analyticepidemiology)
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Steps for Outbreak Investigation
1. Preparation
Health coordination meetings
Use data from surveillance system
Review local directives or plans foreach disease
Assemble your team
Epidemiologist
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Identify and contact Keycommunity contacts
Arrange supplies, equipment
Sample questionnairesPlans for isolation wards
Laboratory support
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2. Detection
a)Surveillance system with early warning
system (EWS) for epidemic pronediseases.
Clustering of cases ordeaths in time and/orspace
Unusual increase in casesor deaths
Acute haemorrhagic feverSevere dehydration
following diarrhoea(usually with vomiting) in
patients >5 years of age
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Acute fever with renal involvement
Acute flaccid paralysis in a childAcute fever with painful lymph nodes
Acute febrile severe illness ofunknown aetiology
Occurrence of two or moreepidemiologically linked cases ofmeningitis
Even a single case of measles or anyother epidemic prone diseases
from a tribal or other poorlyaccessible area
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Unusual isolates
Shifting in age distribution of
casesHigh vector density
Natural disasters
b)Notify ministry of health and WHO in case of outbreaks of specific diseases c) Take appropriate specimens (stool,
CSF or serum) for laboratory confirmation d) Include case in the weekly report
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3. Response
a) Confirm the outbreakDetermine if disease incidence is
higher than backgroundlevel
How do you determine backgroundlevel? -surveillance
Reasons for Observed >Expected
Change in case definitionChange in reporting procedures
Increased awareness or interest
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Improved diagnostics
New clinicianChange in Population
True increase
Activate the outbreakcontrol team
Investigate the outbreak
Control the outbreak
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b)Define and identify cases in terms of time,place and person distribution
c)Establish Case Definition and classify as
confirmed, probable, suspectd)Identify Population At Risk (that would
serve as denominator to calculateattack rate)
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4. Evaluation
Assess appropriateness andeffectiveness of containmentmeasures
Assess timeliness of outbreak
detection and responseChange public health policy if indicated
Write and disseminate outbreak report
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Possible Control Measures for
Different Communicable Diseases
ARIEarly recognition and treatment
All children with cough carefullyassessed
Assess signs of malnutritionRefer severely malnourished to
hospital
Manage pneumonia with antibioticsFollow national treatment protocols
Supportive measures
Vaccination against measles,
diphtheria and whooping cough
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Thank You