Medical systems Collaboration and Communications (C2) blog

December 25, 2008

Health center purchases ham radios for emergency communications

Filed under: Uncategorized — dandeakin @ 23:03
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By Amber Christian
Boonville Daily News

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Boonville, Mo. -The Cooper County Public Health Center is aiming to strengthen the public health system with the purchase of two new stationary ham radios.
The use of ham radios will allow the health center to have uninterrupted contact with the Department of Health and Senior Services and with the local Emergency Operations Center.
CCPHC administrator Melanie Hein explained that having ham radios is a very important part of communicating during an emergency.
“Ham radios do not fail when regular cell phone towers and frequencies fail,” Hein explained. She said that after the disater in New Orleans, ham radios were the only way for emergency communications.
Hein said that while ham radios may seem like old technology, they are the “old tried and true.”
Purchasing the ham radios was the first step. The next step is obtaining an operators license. Hein said that training isn’t required, but the staff is required to pass a test. CCPHC staff will be trained in early 2009 and will be provided by local Ham radio operators.
The ham radios were purchased with Community Pandemic Preparation Planning funds.

December 13, 2008

Early warning for pandemic – Global Viral Forcasting Initiative

Filed under: Disease — dandeakin @ 20:48
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http://www.cnn.com/2008/WORLD/africa/12/08/pip.zoonotics/index.html?iref=mpstoryview

“The centerpiece of Wolfe’s work is trying to stop the next pandemic before it starts. He’s using a recent $11 million grant from Google and the Skoll Foundation to continue something called the Global Viral Forecasting Initiative or GVFI. It’s a kind of early-warning system to track the transmission of viruses in virus hot spots around the world. In addition to Cameroon, Wolfe has teams in the Democratic Republic of Congo, China, Malaysia, Madagascar and Laos.”

December 3, 2008

Age of Pandemics from the Herald Tribune

In age of pandemics, human and animal health intersect

Published: Tuesday, December 2, 2008 at 1:00 a.m.
Last Modified: Monday, December 1, 2008 at 5:40 p.m.

Our nation voted for change in the last presidential election. The world community appears to approve. A strategy for fast-forwarding health care change is also receiving a heavy and favorable voter turnout globally in the scientific electorate. Unfortunately, very few in the general population are aware of this dynamic process and its great potential.

The “One Health Initiative” is a movement to forge co-equal, all inclusive communications and collaborations between physicians, veterinarians and other scientific-health related disciplines. This has been limited or absent for much of the 20th century.

When properly implemented, the sharing of scientific information will help protect and save millions of lives in present and future generations. The One Health concept is a worldwide strategy for expanding interdisciplinary interactions in all aspects of health care for humans and animals. The synergism achieved will accelerate biomedical research, enhance public health efficacy, expand the scientific knowledge base, and improve medical education and clinical care.

In the past two years, “One Health” has expanded exponentially in the scientific communities of the U.S. and many other countries. Nearly two dozen international organizations have endorsed the project, including the American Medical Association, the American Veterinary Medical Association, the Centers for Disease Control and Prevention and the American Society for Microbiology.

Several public health officials at the Florida State Department of Health have worked diligently to support and promote this endeavor. In fact, their division of environmental health publishes a quarterly One Health Newsletter online doh.state.fl.us/Environment/community/One_Health/OneHealth.html. This Web site has gained increasing attention.

This concept has worked with extraordinary synergistic results in the 19th and 20th centuries. Three examples are:

1. A physician and veterinarian research team in 1893, Drs. Theobald Smith and F.L. Kilbourne, discovered the cause of cattle fever, Babesia bigemina, and that it was being transmitted by ticks. This work helped set the stage for the discovery by Walter Reed and his colleagues of the transmission of yellow fever in humans.

2. The Ebola virus was identified as the cause of Ebola hemorrhagic fever in the 1970s through the collaboration of veterinarian Fred Murphy and physician Karl Johnson. These two made history by working closely together at the CDC on this and other topics. Hemorrhagic fever viruses are now designated by CDC as bioterrorism agents.

3. Rolf Zinkernagel (physician) and Peter Doherty (veterinarian) working together as immunologists, discovered how the immune system tells normal cells from virus-infected cells. For this, they received the 1996 Nobel Prize for physiology or medicine.

In the early 21st century, emergence of deadly diseases classified as zoonoses, i.e., diseases of animal origin transmissible to humans highlighted the need for “One Health.” In fact, nearly 75 percent of recently emerging infectious diseases affecting humans are zoonoses. Examples are acquired immune deficiency syndrome, SARS (severe acute respiratory syndrome), West Nile virus and Avian Influenza H5N1. These present the urgent need for human and veterinary medicine to renew and increase collaborative efforts.

Other research on conditions such as cancer, heart disease, diabetes, biomechanical devices and obesity offers golden opportunities for interdisciplinary collaborations.

In 2006, Ronald M. Davis, then-president of the AMA, and AVMA president Roger Mahr struck up a unique liaison between their respective organizations. This resulted in adoption of a historic AMA One Health resolution in June 2007. Several other international health care and scientific organizations followed their lead.

An AVMA One Health task force recently formulated plans for implementing this life protecting/lifesaving strategy. The eventual formation of a “National One Health Commission” is being carefully considered. More information about this project is available on the One Health Initiative web site at onehealthinitiative.com.

Bruce Kaplan is a veterinarian who lives in Sarasota. He has held positions in public health with the Centers for Disease Control and Prevention as an epidemiologist and the USDA’s Office of Public Health and Science in Washington, D.C.

This story appeared in print on page A10

November 30, 2008

Synthetic Viruses Could Explain Animal-to-Human Jumps

Filed under: Uncategorized — dandeakin @ 17:49
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By Brandon Keim EmailNovember 24, 2008 | 5:56:51 PMCategories: Medicine & Medical Procedures, Synthetic Biology

Syntheticsars

In a technical tour de force with potentially profound implications for the study of emerging diseases, researchers have built the largest-ever self-replicating organism from scratch.

The organism is a virus based on genome sequences taken from a bat-borne version of SARS, a lethal respiratory disease that jumped from animals to humans in 2002. The synthetic virus could help explain how SARS evolved, and the same approach could be used to investigate other species-hopping killers.

“This gives us a system to more quickly answer the questions of where a virus came from, of how to develop vaccines and treatments for a brand-new virus that leaps to humans like SARS did,” said Vanderbilt University microbiologist Mark Denison.

Just a decade ago, artificially constructed viruses seemed like science fiction. But the field of synthetic biology has progressed with extraordinary rapidity. Six years ago, polio became the first virus to be synthesized. Three years ago, biologists reconstructed an influenza strain from the 1918 epidemic, in the process discovering what made it so lethal. The synthetic SARS virus is even more complicated than either of those creations. And as such research has progressed, concerns have intensified over viruses jumping from animals to people, then spreading rapidly through a globalized world of international travel and migration.

In some cases, scientists might — as with SARS — suspect the identity of the original animal virus, but not understand the murky process by which it became infectious in humans. In other cases, they might want to know what is needed for an existing animal virus to enter people. But it’s not always easy to study viruses: many are impossible to grow in a lab, or known from just a few wild samples. That’s when synthetic viruses could be useful.

“It can be very hard to study where a virus originally came from,” said Denison. “If you start from where you think the virus was, and let the virus tell you where it’s going, then you learn a tremendous amount about viral evolution and movement.”

In the case of SARS, which killed nearly 800 people before being contained, scientists think it came from bats, but have been unable to keep the bat version alive in laboratory cell cultures.

Denison’s team used the genetic sequence of bat SARS to build the virus. Bat SARS doesn’t normally infect people, but the researchers added a critical tweak: a gene present only in the human version of the virus. The new version flourished in human cell cultures, suggesting that a mutation in the gene, known as Bat-SRBD, was responsible for SARS’ lethal spread.

The new virus did not kill mice, however. Other genetic differences between the synthetic and natural strains can now be studied to learn what makes SARS so virulent, said Denison, and the technique applied to other viruses similar to SARS. These include the Ebola, Hanta, Nipah and Chikunguya viruses, all of which originated in animals and are lethal to people.

“You could get to a point where, within a couple weeks of an epidemic being identified, you’ve already grown and generated viruses for the study of immune response,” said Denison.

Whether the technique is useful elsewhere remains be seen, but “there’s a good possibility” that it will, said Peter Palese, a Mount Sinai Medical Center microbiologist. Palese edited the paper, published today in the Proceedings of the National Academy of Sciences, but was not involved in the research itself.

Even if it’s experimental, he said, researchers need to try.

“If we were successful with conventional approaches,” said Palese, “then they would have worked already.”

Synthetic recombinant bat SARS-like coronavirus is infectious in cultured cells and in mice [PNAS]

Image: Synthetic SARS virus (tagged with fluorescent green protein) growing in mouse respiratory tissue / PNAS

WiSci 2.0: Brandon Keim’s Twitter stream and Del.icio.us feed; Wired Science on Facebook.

November 13, 2008

World Bank says flu pandemic could cost $3 trillion.

Filed under: Uncategorized — dandeakin @ 07:07
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CIDRAP. “World Bank says flu pandemic could cost $3 trillion.” CIDRAP News, Oct 17, 2008. At: http://www.cidrap.umn.edu/cidrap/content/influenza/biz-plan/news/oct1708economy.html

“An internal report prepared by the World Bank estimates that a severe influenza pandemic could kill 71 million people and cause a recession costing more than $3 trillion… The report says that in a severe pandemic, sagging tourism, transportation, retail sales, and productivity, coupled with worker absenteeism, could reduce global gross domestic product (GDP) by 4.8%…

“The new report increases the economic impact estimates made by the World Bank in June 2006. At that time the bank estimated GDP would drop by 3.1%, or about $2 trillion… The story did not explain why the estimates have changed.

“Bank officials estimate that a “mild” pandemic, similar to the Hong Kong flu of 1968-69, could kill 1.4 million people and reduce global GDP by 0.7% in the first year…

“The projection for a “moderate” pandemic like that of the Asian flu in 1957-58 is that it could cause 14.2 million deaths and reduce global economic activity by 2%…

“The bank report also notes that some experts have estimated a death toll ranging from 180 million to 250 million in a severe pandemic.

“World Bank predicts that changes in individual behavior, such as avoiding air travel, restaurants, and mass transportation, could account for 60% of the costs during a pandemic, the story said.

“In regard to economic impact, “People’s efforts to avoid infection are five times more important than mortality and more than twice as important as illness,”… In the worst case, the authors estimate that air travel, tourism, restaurant business, and use of mass transit could drop 20% for the first year.

“The World Bank’s estimate of a 4.8% drop in GDP in a severe pandemic is slightly lower than some other estimates of the hit on the global and US economies. For example, researchers at Australian National University predicted that an “ultra” pandemic would slash global GDP by 5.5%.

“In 2007, the health advocacy group Trust for America’s Health estimated that US economic activity would shrink 5.5% in a 1918-like pandemic. And in 2005 the Congressional Budget Office projected that a pandemic would cut the US GDP by 5%….Bloomberg…citing a United Nations official, also said world leaders will be asked to contribute about $500 million for avian flu control and pandemic preparedness when they meet Oct 24 to 26 in Egypt for the Sixth International Ministerial Conference on Avian and Pandemic Influenza.

“In other developments, [see below] the British insurance market Lloyd’s released a report on the possible effects of a pandemic on the insurance industry. The report says a pandemic on the scale of 1918’s could reduce economic activity by anywhere from 1% to 10%.

“Economic impacts are likely to occur and a pandemic as severe as 1918 may lead to a global recession with reductions of between 1% and 10% of GDP,” it states. “These may impact the general business environment.”

Lloyd’s. Pandemic: Potential Insurance Impacts (Lloyd’s Emergency Risks Team Report). London UK: Lloyd’s, October 16, 2008, 27 pages. Accessed at: http://www.lloyds.com/NR/rdonlyres/08B1357D-AD59-4C48-8064-599AF6F4F340/0/ER_Pandemic_InsuranceImpacts.pdf

Executive Summary:

1. A pandemic is inevitable. With historic recurrence rates of 30-50 years it is prudent to assume that a pandemic will occur at some point in the future. The severity of such events is highly variable; some estimates suggest the most severe to date, in 1918, killed up to 100m. Many pandemics affect the old and young; but some (including the 1918

event) can, perversely, affect the most healthy.

2. 1918 may not be a worst case. It is certainly true that the 1918 event was extreme relative to other pandemics in history. However many published “worst case” scenarios take 1918 as a base. There is a danger that we over optimise to this one scenario. There are other forms of pandemic than influenza, some have higher case mortality. Pandemic

preparedness should consider a range of scenarios to ensure plans are appropriately flexible.

3. Economic impacts may be significant. A repeat of the 1918 event is expected to cause a global recession with estimated impacts ranging from 1% to 10% of global GDP. Most industries will be affected, some more than others. In particular, industries with significant face to face contact will be impacted significantly. Insurers investment assets may be affected depending on the mix held. Wider economic and social effects may lead to secondary forms of loss for insurers.

4. Many insurance losses are possible. For some classes of business such as, life and health it is clear that the impact will be adverse. For other classes of business it is less clear but many forms of liability covers including general liability, D&O, Medical Malpractice as well as specific products offering business interruption and event

cancellation could be triggered. Inner limits for Pandemic losses (vertical and sideways) may help to contain exposure.

5. Secondary impacts may occur. Events causing significant global and societal turmoil can give rise to considerable secondary impacts. It is far from clear which of these, if any, would occur; but for resilience planning purposes it is worth considering them. For

example the lawlessness experienced in New Orleans after Katrina could be repeated if police services are affected. Traditional claims such as fire loss may be exacerbated if fire emergency services have depleted efficiency and if tradesmen are in short supply.

The 2006 World Bank report noted above can be accessed at:

Burns, Andrew, et al. Evaluating the Economic Consequences of Avian Influenza. Prospects Group, World Bank Development Economics Directorate, October 6, 2006, 6 pages. Accessed at: http://siteresources.worldbank.org/INTTOPAVIFLU/Resources/EvaluatingAIeconomics.pdf

November 6, 2008

Pandemic Reporting System

Filed under: Uncategorized — dandeakin @ 19:49
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Pandemic reporting system will speed lab info exchange

By Heather B. Hayes
Published on October 10, 2008

Related story links
Alert net set to go national

Lab test dummies

Spying on epidemics

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The Centers for Disease Control and Prevention awarded a $258,000 grant to the Iowa Public Health Department and the University Hygienic Laboratory (UHL) to develop an electronic interface to speed the exchange of test results in the event of a pandemic.

The Automated Electronic Influenza Reporting System, which is expected to take a year to complete, will enable the UHL — Iowa’s state laboratory — the Nebraska Public Health Laboratory and the Minnesota Public Health Laboratory to electronically order tests from one another on an as-needed basis and then transmit results back without any human intervention.

The interface, says Dari Shirazi, IT manager of the UHL, will significantly speed the process of getting laboratory findings back to physicians and give each lab an immediate heads-up on what tests are coming, so the receiving lab can successfully plan for a surge.

Currently, cross-lab tests are ordered by phone and fax and can take several manual steps and several days just to get results back. That type of process will not suffice in the event of a pandemic, Shirazi said. “This system gives us quite a lot more capability to order off of other laboratory systems when we are short-handed or at capacity.”

The system, thought to be the first of its kind, will rely on the Health Level 7 health messaging standard to create test-order and result messages so they can be understood by the different Laboratory Information Management Systems.

Shirazi said the biggest challenge in creating the interface will be to come up with common ways to report information, including how tests are named, how results are displayed and what patient information is required.

“We’ll need to figure out how each information system defines all of these fields, find the commonality and then figure out how we can talk to each other,” Shirazi said. “And it all has to be done upfront.”

The hope and goal with this system “is to do this in a way that other states can eventually implement it and benefit from it so everybody doesn’t have to reinvent the wheel,” he added.


CDC Grants and Public Health Emergency Response

Filed under: Uncategorized — dandeakin @ 19:46
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CDC grants to bolster emergency response systems

By Heather B. Hayes
Published on October 13, 2008

Related story links
HHS hands out $1 billion for emergency response upgrades

Spying on epidemics

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Subscribe to the Government Health IT newsletter to receive all the latest in news, features and online resources.

The Centers for Disease Control and Prevention awarded a total of $27 million to seven universities and a public health research firm to help first responders cope with a pandemic or other health emergency.

The CDC awarded a $16.9 million, one-year contract to American Type Culture Collection in Manassas, Va., to develop the CDC Influenza Reagent Resource (CDC-IRR), a secure Web-based system to improve access to influenza viruses, test kits and testing substances for approved laboratories.

The nonprofit firm focuses on acquiring and authenticating standard reference micro-organisms, cell lines and other materials for research in the life sciences.

The system will provide public health officials better access to testing resources through a secure Internet Web portal. Should a pandemic occur, labs will be essential for a quick response by detecting and confirming initial cases and monitoring the pandemic’s progression.

“We expect the CDC-IRR will speed the development of better diagnostic tests, antiviral drugs and vaccines,” said Dr. Nancy Cox, director of the Influenza Division at the CDC, said.

The CDC also announced in early October awards of $10.9 million to schools of public health to create Preparedness and Emergency Response Research Centers (PERRCs).

The centers “will connect public health with scientists involved in business, engineering, legal and social sciences to incorporate multiple perspectives into preparedness and response research which can be used to strengthen our nation’s response capability,” according to Dr. Richard Besser, director of CDC’s Coordinating Office for Terrorism Preparedness and Emergency Response.

The awards went to the Harvard School of Public Health, Emory University, Johns Hopkins University, the University of North Carolina-Chapel Hill, the University of Minnesota, the University of Pittsburgh and the University of Washington.

They will use the money to create sustainable preparedness systems and generate metrics to measure the effectiveness and emergency response systems.

November 4, 2008

Transportation Pandemic Planning Guidance Material

Filed under: Uncategorized — dandeakin @ 22:01
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Department of Transportation. DOT Pandemic Flu Planning (Website). Accessed at: http://www.dot.gov/pandemicflu/

DOT has place five annexes on the web “intended to assist the Transportation Sub-Sectors, and associated public and private sector businesses plan for a severe influenza pandemic”:

Aviation
Highway/Motor Carrier
Maritime,
Mass Transit
Railroad Sub-Sector Pandemic Influenza Planning Guidelines (annexes).

“These Sector-specific guidelines are annexes to the Pandemic Influenza Preparedness, Response, and Recovery Guide for Critical Infrastructure and Key Resources developed by the Department of Homeland Security and posted at: http://www.pandemicflu.gov/plan/pdf/cikrpandemicinfluenzaguide.pdf

October 31, 2008

Vaccine Production, Distribution Should Lead Future HHS Pandemic Agenda

Filed under: Uncategorized — dandeakin @ 00:52
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Fowler, Daniel.  “Vaccine Production, Distribution Should Lead Future HHS Pandemic Agenda.”  CQ Homeland Security, October 29, 2008. 

 

HHS Secretary Michael O. Leavitt recommends that his successor focus on four key areas relating to pandemic flu preparedness, including completion of vaccine production facilities and distribution of countermeasures.

 

“I believe that we can finish our service knowing that we are better prepared today than we were in spring 2005, not just for pandemics, but for all hazards,”…. The secretary also emphasized the need to continually remind states, businesses and families about “their responsibility to be prepared” and to “defend strongly the global sample-sharing network internationally, against short-term opportunism.”

 

…. In terms of the country’s countermeasure strategy, Leavitt called distribution its “Achilles’ heel.”   

 

“Within 12 hours, we can put massive amounts of medical countermeasures, and medical supplies at virtually any location within the United States,” he said. “However, getting pills into the palms of people’s hands fast is critical, and not every state is adequately prepared to carry that out.”

 

According to Leavitt, “This is a serious problem because, in the case of anthrax, for example, or in some other biologic attack, the survival-rates decline rapidly after 48 hours.” 

NORTHCOM has ‘fully come of age,’ according to outside assessment

Filed under: Uncategorized — dandeakin @ 00:49
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Peters, Katherine McIntire.  “NORTHCOM has ‘fully come of age,’ according to outside assessment.”  Government Executive, October 29, 2008.  Accessed at:  http://www.govexec.com/dailyfed/1008/102908kp1.htm

 Excerpts: 

 Six years after it was established to better coordinate military support to civil authorities following catastrophic events on U.S. soil, Northern Command “is effectively providing coordinated and coherent planning and direction to U.S. air-ground-sea forces in support of homeland defense and civil support,” according to a recent assessment by retired Army Gen. Barry McCaffrey, an adjunct professor of international affairs at the U.S. Military Academy at West Point, N.Y.  More must be done, however, to increase the capacity of civilian agencies to respond to threats, McCaffrey wrote in an Oct. 14 memo to academy leaders….

 ”The American people rightly demand that civil public institutions, not military forces, exercise primacy in protecting the U.S. domestic population. However, the planning and emergency operational scale and power of the U.S. armed forces simply must be placed at the service of civil authorities when major disaster strikes,” something Northern Command finally is in a position to do, McCaffrey said.

 Three forces have forged a new sense of “confidence and effectiveness” at the command, according to McCaffrey:

 

·        Command leaders were able to exploit the “sad lessons” of Hurricane Katrina, “the most shameful failure of federal, state and local leadership in any national emergency in our history,” he said.

 

·        Defense Secretary Robert Gates fostered partnerships between Northern Command and the Homeland Security Department, state governors and other international and interagency actors.

 

·        Northern Command leaders created a cooperative training and exercise environment to work through responses to scenarios such as pandemic influenza, a cruise missile attack, an attack on commercial aircraft, loss of the power grid, a major earthquake and other potential threats

 

·        “The Byzantine federal-state political and legal difficulties of putting together a coherent national emergency response plan are being overcome by the obvious benefits of cooperating with the massively resourced (comparatively) and extremely effective U.S. armed forces,” McCaffrey said. “NORTHCOM has the ability to plan and execute large-muscle complex operations. NORTHCOM can pay the bills.”….

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