Laboratory network for EID response

DDC /MOPH perspectives

Supamit Chunsuttiwat

Science Park

31 March 2016

Most EIDs are zoonotic & viral

Key strategies in EID management

Prevention

Preparedness

Response

Recovery

Prevent Prepare Respond Recover

Key strategies in EID management

Prevent Prepare Respond Recover

Reduce risk • Sanitation • Hygiene • Vector control • Etc.

Build capacities • Surveillance capacity • Laboratory capacity • Hospital capacity • Stockpiling & logistics • Planning & exercises • R & D

Mitigate loss • Early detection • Outbreak investigatn • Outbreak control • Case manage. & IC • Risk communication • Incident command

Return to normal

• Physical • Mental • Social • Economic

Key strategies in EID management

Prevent Prepare Respond Recover

Reduce risk • Sanitation • Hygiene • Vector control • Etc.

Build capacities • Surveillance capacity • Laboratory capacity • Hospital capacity • Stockpiling & logistics • Planning & exercises • R & D

Mitigate loss • Early detection • Outbreak investigatn • Outbreak control • Case manage. & IC • Risk communication • Incident command

Return to normal

• Physical • Mental • Social • Economic

Key strategies in EID management

EID detection triad

Laboratory

Clinical Epidemio-logical

Diagnosis

Turning crises into opportunities

Major capacities built in the response to SARS, 2003

• Surveillance & Laboratory o epidemiologic definition adopted for

early detection o MOPH-US CDC cooperation initiated for

serologic testing; NSTDA collaboration with universities initiated

• Stockpiling o PPE stockpiling initiated

• Hospital infection control o BIDI accelerated hospital infection

control system o IC in public hospital activated, BIDI

serving as training center for hospital IC

Turning crises into opportunities

Major capacities built in the response to avian influenza, 2004

• Surveillance & laboratory o ILI surveillance initiated o PCR lab expanded – 12 regional labs. ,

confirmation at DMSc & universities o NSTDA support on rapid test develop. o SRRT expanded

• Stockpiling o Oseltamivir stockpile initiated o PPE stockpile increased

• Risk communication o Local RC networking strengthened

• National Committee established

• National plan on AI and PIP created

• Simulation exercise initiated and carried out at various levels

Turning crises into opportunities

Major capacities built in preparedness & response to pandemic influenza H1N1 2009 (1)

• Surveillance & laboratory o ILI, SARI surveillance strengthened o PCR lab further expended, confirmation

available in 24 hours

• Stockpiling & logistics o Oseltamivir expanded, local production

established o PPE stockpile expanded

• Vaccine capacity o Influenza vaccine manufacture project

approved o R&D for pandemic vaccine supported

under WHO GAP (started with H1N1, H5N1)

o National influenza immunization program initiated

Turning crises into opportunities

Major capacities built in preparedness & response to pandemic influenza H1N1 2009 (2)

• Hospital IC expanded countrywide, an isolation room in all public hospitals

• National Committee on AI & PIP maintained, later modified to National EID Com,

• National Plan on AI & PIP revised, modified to National EID Plan

• Simulation exercise maintained and supported by DDPM/MOI, BCP planning encouraged

Turning crises into opportunities

Major capacities built in preparedness to Ebola (1)

• Surveillance network strengthened o Traveler surveillance at POE

oDetection at health facility

oCommunity participation

• DRA established in main med. centers set for handling lab specimens of suspect Ebola

• Lab networking to fasten detection of Ebola, confirmation available DMSc & CU

Turning crises into opportunities

Major capacities built in preparedness to Ebola (2)

• National committee reactivated to oversee Ebola risk management

• Multisectoral cooperation extended, roles of armed forces and local admin. enhanced in preparedness planning for Ebola introduction and outbreak

• R&D on Ebola initiated (Siriraj research team)

Turning crises into opportunities

Major capacities built in preparedness and response to MERS

• Hospital IC capacity assessed and maintained

• Surveillance • SRRT trained to closely monitor Hajj

pilgrims & travelers from ME • Lab networking established for MERS

testing, 14 central and regional labs under DMSc; confirmation available at DMSc & universities

• National committee and cabinet kept informed on Ebola prep and response

• Simulation exercise conducted annually in high risk provinces

Thailand confirms first MERS case in visitor from Oman

BBC 19 June 2015

Thai officials disinfected the aircraft the 75-year-old man was on from Oman to Bangkok Thailand has confirmed its first case of Middle East Respiratory Syndrome (Mers), the deadly virus that has killed 24 people in South Korea.

The man is now in quarantine at an infectious diseases facility outside the capital Bangkok.Thai health officials said the 75-year-old from Oman was seeking treatment for a heart problem in Bangkok. Nearly 60 people who came into contact with the patient have been identified. That includes three relatives who travelled with him on the plane.

Social loss : 283 human cases 110Deaths Economic loss : Pig destruction (1.4 mil.) US$ 400 million Identification of aetiology International collaboration: Malaysia-Australia

Nipah - Malaysia 1999

Flying Fox

Key issues in HFMD response

• Public health

• Surveillance

• Laboratory investigation

• Prevention & Control

• Case management

• Risk communication

• Public Communication

Inter-

Depart.

Inter-

Sector.

Collab-

oration

ICS

Expert

advisory

Geographical distribution of Zika virus disease

Expectations of laboratory capacities for EID management: DDC perspective

Availability

Speed

Quality/ reliability

Sustainable/ self-reliance

Affordability/ cost-effectiveness

Advancement

Benefits of Lab networking

• Prompt response • Development • Quality / standard • Work load sharing • HRD • Other

ที่มา : กรมอาเซียน กระทรวงการตา่งประเทศ

เตรยีมพรอ้มเขา้สูป่ระชาคมอาเซยีน

พรอ้มแขง่ขนั?

พรอ้มรว่มมอื

Summary • Critical role of laboratory network in EID response

• Speedy & reliable lab testing is critical for EID detection & response.

• National lab capacities determines EID preparedness and response

• Appreciation of lab collaboration in earlier EID responses • SARS /MERS, Avian / Pandemic influenza, Ebola, Nipah, etc.

• Great opportunities and potential of national lab networking

• Expectation of national laboratory capacities • Networking – extensive and tight, national & international

• Surge capacity & development

• Sustainability / self-reliance / security

• Quality

Thank you Terima kasih

Salamat Cam on

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