A model of reporting and controlling outbreaks by public health agencies


Book Description

When an outbreak of an infectious disease is suspected, a local health agency may notify a state or federal agency and request additional resources to investigate and, if necessary, contain it. However, due to capacity constraints, state and federal health agencies may not be able to grant all such requests, which may give an incentive to local agencies to request help strategically. We study a model of detection and control of an infectious disease by local health agencies in the presence of imperfect information about the likelihood of an outbreak and limited diagnostic capacity. When diagnostic capacity is rationed based on reports of symptoms, the decision to report symptoms or not creates a trade-off. On the one hand, rigorous testing allows one to make an informed disease control decision. On the other hand, it also increases the probability that the disease will spread from an untested area where fewer precautionary measures are taken. Symptoms are overreported (respectively, reported truthfully, or underreported) when the cost of disease control is sufficiently small (respectively, in some intermediate range, or sufficiently large). If the disease incidence decreases or infectiousness increases, symptoms are reported less frequently. If the precision of private signals increases, the extent of overreporting of symptoms may increase. For different values of the parameters it can be socially optimal to subsidize or tax requests for additional investigations and confirmatory testing.




Public Health Systems and Emerging Infections


Book Description

The Forum on Emerging Infections was created in 1996 in response to a request from the Centers for Disease Control and Prevention and the National Institutes of Health. The goal of the forum is to provide structured opportunities for representatives from academia, industry, professional and interest groups, and government to examine and discuss scientific and policy issues that relate to research, prevention, detection, and management of emerging infectious diseases. A critical part of this mission has been the convening of a series of workshops. Public Health Systems and Emerging Infections summarizes the fourth in a series of five workshops. With a focus on our knowledge and understanding of the role of private and public health sectors in emerging infectious disease surveillance and response, the participants explored the effects of privatization of public health laboratories and the modernization of public health care. The issues discussed included epidemiological investigation, surveillance, communication, coordination, resource allocations, and economic support.




The Future of Public Health


Book Description

"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.




Learning from SARS


Book Description

The emergence of severe acute respiratory syndrome (SARS) in late 2002 and 2003 challenged the global public health community to confront a novel epidemic that spread rapidly from its origins in southern China until it had reached more than 25 other countries within a matter of months. In addition to the number of patients infected with the SARS virus, the disease had profound economic and political repercussions in many of the affected regions. Recent reports of isolated new SARS cases and a fear that the disease could reemerge and spread have put public health officials on high alert for any indications of possible new outbreaks. This report examines the response to SARS by public health systems in individual countries, the biology of the SARS coronavirus and related coronaviruses in animals, the economic and political fallout of the SARS epidemic, quarantine law and other public health measures that apply to combating infectious diseases, and the role of international organizations and scientific cooperation in halting the spread of SARS. The report provides an illuminating survey of findings from the epidemic, along with an assessment of what might be needed in order to contain any future outbreaks of SARS or other emerging infections.




Infectious Disease Surveillance


Book Description

This fully updated edition of Infectious Disease Surveillance is for frontline public health practitioners, epidemiologists, and clinical microbiologists who are engaged in communicable disease control. It is also a foundational text for trainees in public health, applied epidemiology, postgraduate medicine and nursing programs. The second edition portrays both the conceptual framework and practical aspects of infectious disease surveillance. It is a comprehensive resource designed to improve the tracking of infectious diseases and to serve as a starting point in the development of new surveillance systems. Infectious Disease Surveillance includes over 45 chapters from over 100 contributors, and topics organized into six sections based on major themes. Section One highlights the critical role surveillance plays in public health and it provides an overview of the current International Health Regulations (2005) in addition to successes and challenges in infectious disease eradication. Section Two describes surveillance systems based on logical program areas such as foodborne illnesses, vector-borne diseases, sexually transmitted diseases, viral hepatitis healthcare and transplantation associated infections. Attention is devoted to programs for monitoring unexplained deaths, agents of bioterrorism, mass gatherings, and disease associated with international travel. Sections Three and Four explore the uses of the Internet and wireless technologies to advance infectious disease surveillance in various settings with emphasis on best practices based on deployed systems. They also address molecular laboratory methods, and statistical and geospatial analysis, and evaluation of systems for early epidemic detection. Sections Five and Six discuss legal and ethical considerations, communication strategies and applied epidemiology-training programs. The rest of the chapters offer public-private partnerships, as well lessons from the 2009-2010 H1N1 influenza pandemic and future directions for infectious disease surveillance.




Evidence-Based Practice for Public Health Emergency Preparedness and Response


Book Description

When communities face complex public health emergencies, state local, tribal, and territorial public health agencies must make difficult decisions regarding how to effectively respond. The public health emergency preparedness and response (PHEPR) system, with its multifaceted mission to prevent, protect against, quickly respond to, and recover from public health emergencies, is inherently complex and encompasses policies, organizations, and programs. Since the events of September 11, 2001, the United States has invested billions of dollars and immeasurable amounts of human capital to develop and enhance public health emergency preparedness and infrastructure to respond to a wide range of public health threats, including infectious diseases, natural disasters, and chemical, biological, radiological, and nuclear events. Despite the investments in research and the growing body of empirical literature on a range of preparedness and response capabilities and functions, there has been no national-level, comprehensive review and grading of evidence for public health emergency preparedness and response practices comparable to those utilized in medicine and other public health fields. Evidence-Based Practice for Public Health Emergency Preparedness and Response reviews the state of the evidence on PHEPR practices and the improvements necessary to move the field forward and to strengthen the PHEPR system. This publication evaluates PHEPR evidence to understand the balance of benefits and harms of PHEPR practices, with a focus on four main areas of PHEPR: engagement with and training of community-based partners to improve the outcomes of at-risk populations after public health emergencies; activation of a public health emergency operations center; communication of public health alerts and guidance to technical audiences during a public health emergency; and implementation of quarantine to reduce the spread of contagious illness.




Infectious Disease Movement in a Borderless World


Book Description

Modern transportation allows people, animals, and plants-and the pathogens they carry-to travel more easily than ever before. The ease and speed of travel, tourism, and international trade connect once-remote areas with one another, eliminating many of the geographic and cultural barriers that once limited the spread of disease. Because of our global interconnectedness through transportation, tourism and trade, infectious diseases emerge more frequently; spread greater distances; pass more easily between humans and animals; and evolve into new and more virulent strains. The IOM's Forum on Microbial Threats hosted the workshop "Globalization, Movement of Pathogens (and Their Hosts) and the Revised International Health Regulations" December 16-17, 2008 in order to explore issues related to infectious disease spread in a "borderless" world. Participants discussed the global emergence, establishment, and surveillance of infectious diseases; the complex relationship between travel, trade, tourism, and the spread of infectious diseases; national and international policies for mitigating disease movement locally and globally; and obstacles and opportunities for detecting and containing these potentially wide-reaching and devastating diseases. This document summarizes the workshop.




The Emergence of Zoonotic Diseases


Book Description

Zoonotic diseases represent one of the leading causes of illness and death from infectious disease. Defined by the World Health Organization, zoonoses are "those diseases and infections that are naturally transmitted between vertebrate animals and man with or without an arthropod intermediate." Worldwide, zoonotic diseases have a negative impact on commerce, travel, and economies. In most developing countries, zoonotic diseases are among those diseases that contribute significantly to an already overly burdened public health system. In industrialized nations, zoonotic diseases are of particular concern for at-risk groups such as the elderly, children, childbearing women, and immunocompromised individuals. The Emergence of Zoonotic Diseases: Understanding the Impact on Animal and Human Health, covers a range of topics, which include: an evaluation of the relative importance of zoonotic diseases against the overall backdrop of emerging infections; research findings related to the current state of our understanding of zoonotic diseases; surveillance and response strategies to detect, prevent, and mitigate the impact of zoonotic diseases on human health; and information about ongoing programs and actions being taken to identify the most important needs in this vital area.




BioWatch and Public Health Surveillance


Book Description

Following the attacks of September 11, 2001 and the anthrax letters, the ability to detect biological threats as quickly as possible became a top priority. In 2003 the Department of Homeland Security (DHS) introduced the BioWatch program-a federal monitoring system intended to speed detection of specific biological agents that could be released in aerosolized form during a biological attack. The present volume evaluates the costs and merits of both the current BioWatch program and the plans for a new generation of BioWatch devices. BioWatch and Public Health Surveillance also examines infectious disease surveillance through hospitals and public health agencies in the United States, and considers whether BioWatch and traditional infectious disease surveillance are redundant or complementary.




Public Health Intelligence


Book Description

The first textbook on public health intelligence presents in depth the key concepts, methods, and objectives of this increasingly important competency. It systematically reviews types of evidence and data that comprise intelligence, effective techniques for assessment, analysis, and interpretation, and the role of this knowledge in quality health service delivery. The book’s learner-centered approach gives readers interactive context for mastering the processes of gathering and working with intelligence as well as its uses in informing public health decision-making. And its pragmatic framework will help establish standards for training, practice, and policy, leading to continued improvements in population health. This path-breaking resource: Offers a comprehensive, up-to-date introduction to public health intelligence, a core area of public health competency. Is suitable for both graduates’ and healthcare professionals’ training and development for national and international contexts. Helps readers apply theory to real-life scenarios, from multi-professional perspectives. Features activities, case studies, and discussion tasks for easy reader engagement. Anticipates and examines emerging developments in the field. Public Health Intelligence - Issues of Measure and Method is bedrock reading for postgraduate and advanced undergraduate students in public health, global health, health policy, health service management, nursing, medicine, statistics, epidemiology, quantitative methods, health intelligence, health inequality, and other allied healthcare fields. It is also a salient text for public health practitioners and health policymakers. "This book is a 'must-read' for students contemplating a career in Public Health or for anyone who is already in practice. The breadth of chapters from respected authors provide a detailed overview and critique of issues related to public health intelligence. A key strength of the book is that it is written with both students and practitioners in mind." Gurch Randhawa, PhD, FFPH, Professor of Diversity in Public Health & Director, Institute for Health Research, University of Bedfordshire, UK