Post on 27-Mar-2015
Disasters & EmergenciesHow Infectious Diseases Cause Emergencies
Nancy Blackmore,
Coordinator Preparedness, Planning & Equipment Resource, EHS,
Outline
• Infectious diseases by category
• Bioterrorism
• New & emerging
• Pandemic influenza
• Impact & planning considerations
Infectious [Communicable] Diseases• Endemic
– Normal expected level of disease
• Epidemic– An outbreak with
unusual high numbers
• Pandemic– A world wide
outbreak
• Bioterrorism – 3 categories – E.g. anthrax
• Newly emerging– West Nile virus,– SARS, etc.
• Naturally occurring – E.g pandemics of
influenza
Definition
• Bioterrorism is the use of biological agents to intentionally produce disease or intoxication in susceptible populations to meet the aims of terrorists.
• In addition to the potential medical consequences is the likelihood of human panic – a worthwhile goal in itself for the terrorist group.
Public Reaction• Cannot see, touch or feel it• People can’t get to a safe place, but sit and
wait• Panic!• Increased psychosomatic illnesses • Increased visits to an already overtaxed
emergency department• Health workers themselves may be fearful
and stressed• Hoarding of medical supplies and resources
The Threat
• The Good News - low probability
• The Bad News - huge impact
Organisms & Diseases of “New” Concern to Us:
•West Nile Virus•Lyme disease•Hantavirus•Human Granulocytic Ehrlichiosis•Son of SARS???
What is Pandemic Influenza?
• A new influenza virus arising from a major genetic change [antigenic shift or adaptive mutation]
• The population will be very susceptible with little or no immunity
• The virus will transmit efficiently from person to person
• The virus will be virulent with the capacity to cause serious illness and death
Each Pandemic is Different
H1N1 H2N2
H3N2
1918: “Spanish Flu”
1957: “Asian Flu”
1968: “Hong Kong Flu”
40-50 million deaths
2-4 million deaths
1 million deaths
Credit: US National Museum of Health and Medicine
Source: WHO
• 75% of people will be infected
• 15 – 38% will be clinically ill
• 6.8 – 17% will require outpatient care
• 0.1 – 0.3% will require hospitalization
• 0.03 – 0.1% will die Based on a “flu aid” formula
developed by Meltzer & colleagues, CDC Atlanta http://www.cdc.gov/ncidod/eid/vol5no5/meltzer.htm
• 681,005 will be infected
• 136,201 – 345,042 will be clinically ill
• 61,744 – 154,361 will require out-patient care
• 908 – 2724 will require hospitalization
• 272 – 908 will die
Based on population numbers from 2001 census
Estimating the Impact for Nova Scotia:
Pandemics are Unpredictable• Direct impact of
influenza:– Attack rate [15>35%]– Affected age groups
[unknown until it begins]
– Virulence of the strain and rates of adverse outcomes/complications [mild, moderate or severe?]
– Speed of spread from country to country and within a country [1-3 months to arrive? 2-3 waves? 12-18 months duration?]
• Effectiveness of the response:– Vaccines [not
available for 1st wave]
– antivirals [in stockpile now for treatment]
– non-pharmaceutical interventions [public health measures]
• Psychologically induced impacts/public behaviour
Potential Challenges:• Must maintain mandatory business
[BCM]• Reduce elective or optional services• Cope with simultaneous emergencies
[e.g. hurricanes, storms, etc.]• Prepare for economic consequences• Increased demand for health & social
services• Increased demand for volunteers• Cope with loss of employees
[permanent or temp]
Consequences of Absenteeism: • All sectors impacted: e.g.
manufacturer, transportation, municipal services, etc.
• Possible shortages: e.g. food, fuel, cash in bank machines
• Issues for workers: ill themselves; need self-care info; may have elder or child care needs; fear; may be asked to work outside of usual environment, etc.
Questions?
•The hardest part of responding to an emergency is explaining why we didn’t prepare”