National Capacities of Alert and Response for Infectious Diseases, - - PowerPoint PPT Presentation

National Capacities of Alert and Response for Infectious Diseases, under the IHR(2005) Chile, 2010

Chile, Ministry of Health, Department of Epidemiology

National Policy/Priority: Law (Official publication)

CORE CAPACITY REQUIREMENTS FOR SURVEILLANCE AND RESPONSE

IHR(2005) Implementation

Detection Communication Preliminary control Control, confirmation and support Evaluation and communication to the national Evaluation and notification to WHO Public Health response Local Level Intermediate level National level

Surveillance and Response: What does Chile have for surveillance?

• Legislative background
• Supreme Decree N°158 and

Technical Standard

• IHR: Law (2008)
• Epidemiology Department at

national and regional level (Chile has 15 Regions):

• Epidemiologists, all with master

degree in Public Health, geographer, journalist, computer technicians.

• Network with more than 3000

delegates of epidemiology at local level.

• Multidisciplinary Rapid Response

Team

• Laboratory Network
• National Reference Laboratory and

national laboratories network

• International Networks: WHO

respiratory viruses, WHOGSS y PulseNet Latin America

Surveillance System

Intermediate level

Community Schools Rumors Local laboratory Sanitary Offices in entry poins

Statistics Department – Ministry of Health

Department of Epidemiology Health care Facilities and Hospitals National Reference Laboratory (ISP)

L a b

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a t

• r

y N e t w

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Technical reports, Bulletins, Web site Technical reports

What does Chile have for surveillance?

• Computer development
• Computer equipment upgrade at national and regional level (15)
• Development of differents applications
• Capture Data
• Epidata (Inmediate disease notification, outbrakes)
• Filemaker (Daily notifications)
• On line system (sentinel surveillance)
• ISIS (PAHO’s: AFP surveillance, measles and rubella)
• SIME (PAHO’s: Public Health Event Management)
• Data Analysis
• SPSS
• Epiinfo 6.2, Epiinfo 2002
• Stata
• Arcview
• SigEpi
• Instant Atlas

What does Chile have for surveillance?

• Dissemination and

communication mechanisms

• El Vigía (semestral bulletin),

BEM (monthly electronical bulletin) and

• web page: http://epi.minsal.cl,

www.influenza.cl, bioterrorism

International network

• MERCOSUR, APEC,

PAHO/WHO, ORAS-CONHU

• Network for Emergent diseases
• f South Cone

Department of Epidemiology web site: Bioterrorism

Protocols to response front suspicious packages and envelopes

Emergency Committee of Chemical and Biological Weapons

Since Sept 2001, the WHO made an international call to strengthen national capabilities for responding to the possible use of chemical and biological weapons. On 28 September, the Ministry of Health formed a “Committee for Bioterrorism Risk Assessment”. The Committee is composed of representatives of the following areas:

Epidemiology Department Environmental Health National Reference Laboratory (ISP) Unit of Chemistry and Pharmacy Central Warehouse Healthcare Network Infectious Diseases Advisors Toxicology advisors Communication Department Governmental Institutions : National Government, Ministry of Defense; Fire Department; Military and law enforcement; others.

Protocol Anthrax attack

Investigación epidemiológica Department of Epidemiology: protocols developed in 2001: detect, listing exposes, collect specimens, identify other cases and exposes and indicate chemoprophylaxis: Ciprofloxacine or peniciline. Community, rumors, others Fire Department isolated the place and proceed to decontaminate Police: Specialist Group (GOPE) carries the package to ISP

ISP

Medical Response for anthrax cases Community, rumors, others

What does Chile have for response?

CREATION OF NATIONAL IHR FOCAL POINT Objective: To facilitate national and international communication, information processing and decision making regarding public health. Functioning: 24/7 15 Regional IHR Focal Points in coordination 24/7 with Border Sanitary Offices and National IHR Focal Point.

National Centre for communication with WHO 24/7 Coordinate response: SAG, GOPE, SAMU, FFAA, ONEMI, ISP

Redefinition of Sanitary Procedures

• Revision of the legislative and regulatory background
• Points of entry designations
• Ports, Airports, ground crossings
• Creation of Sanitary Offices (SO) in points of entry
• Sanitary measures
• Manual of procedures
• Contingency plans
• Definition of capabilities
• Information Systems

• Selection Criteria:
• Movement of vessels
• Anual demand for certificates in 2006

and 2007.

• Capacity and geographic distribution
• Survey to establish the capacity to

develop health inspections of ships and issuance of Health Certificates.

• IHR Designated Ports: 19

Port of Valparaíso ‐Chile

Designation of Ports (WHO)

List of chilean ports designated is in the WHO web site: http://www.who.int/ihr/ports_airports/portslanding/es/index.html

Implementation of 6 Sanitary Offices in Entry Points

Human Resources: 29 new officials

• Reduce the risk of

international spread of disease through:

• The adoption of permanent

and effective public health measures and

• The dotation of response

capacities at airports, ports and ground crossings.

IHR, Human Resources dotation

• Budget for implementation of IHR.
• Estimation of needs for the Sanitary Offices (SO):

number of people and infrastructure for the sanitary control

• Airport and SO:
• 3 to 6 people for each SO (total, 29)
• Priority of professionals and technicians in the area of health,

with experience in patient care.

• Designated Ports (to WHO)
• 6 technicians with inspection functions
• 6 paramedic technicians with surveillance functions.

• Manual of Functions of

Designated Entry Points: standarize health measures related to the entry of passengers at airports and ground crossings.

• Contingency Plans:

National level Plans (Example: Pandemic Flu Preparedness), regional levels and for each entry point according to potential risks.

Implementation of Sanitary Offices in Entry Points

Web site: www.pandemia.cl

Basic Capacities in the context of MERCOSUR

Within the framework of MERCOSUR, the instruments of evaluation of capacities were elaborated for:

• Core capacity requirements for surveillance

and response: Annex 1 A of IHR(2005)

• Core capacity requirements for designated

airports, ports and ground crossings: Annex 1 B of IHR(2005) Intention: to know the system monitoring and response capacity for planning the implementation of new capacities in fulfillment of the demands of IHR(2005)

Preliminary results

10 20 30 40 50 60 70 80 90 100

Promedio Marco Legal Administrativo Promedio capacidad para detectar, evaluar y notificar Promedio investigar, intervenir, comunicar

% alcanzado

Porcentaje de cumplimiento de las capacidades basicas de vigilancia y respuesta. Nivel Nacional, Chile 2009.

Percentage of fulfillment of the National basic capacities

International airport of Santiago, Chile.

10 20 30 40 50 60 70 80 90 100

Promedio capacidad para comunicar Promedio capacidad básica de rutina Promedio capacidad para responder ante una ESPII

% alcanzado

Porcentaje de cumplimiento de capacidades básicas, Aeropuerto AMB. Chile, 2008.

Programas de supervisión, Sala aislamiento, Manuales

• peracionales

Next steps

• Plans of Action: actions to address

identified needs in the capacity at national, sub-national and local levels.

Invest in Health, Build a Safer Future • World Health Day 2007

Detection Detection Verifica Verification tion Risk Evaluation Risk Evaluation Response Response

A good surveillance system allows timely and adequate response.

Key: Surveillance

Public Health Emergencies

♦ Human health is an essential component but ..... not all ♦ Responsibility extends to all government and society.

Projections and Challenges

• To develop a multidisciplinary rapid response team
• To develop models of sectorial and intersectorial work

in Sanitary Offices and designated ports.

• To develop training projects to enhance travelers’

health and sanitary inspection of at ports and vessels.

• Simulations to maintain team capacities
• Epidemiology is the first step to detect, identify and

stop outbreaks.

• Intersectorial partnerships are crucial

اﺮﻜﺷ

спасибо

感謝