Principles of Epidemic Preparedness and

Response

Reported Cases of Encephalitis in Nepal, 1997-1998

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Cas

es

1997

1998

Source: EWARS

Objectives of Epidemic Preparedness and Response

1. Anticipation/prediction • so that epidemics be prevented• e.g. meningitis, measles

2. Early detection • to know when there is a problem• e.g. EWARS

3. Rapid Response• guidelines/trained staff/supplies • in place before epidemic

4. Effective Response • appropriate control methods• adequate resources and logistics

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Outbreak Detection and ResponseWithout Preparedness

Delayed Response

DAY

CASESOpportunity for control

Late Detection

First Case

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Outbreak Detection and ResponseWith Preparedness

Rapid Response

DAY

CASES

Early Detection

Potential Cases Prevented

FASTER

BETTER

Components of Epidemic Preparedness

1 Establish Epidemic Committee

2. Set priorities

3. Agree epidemic preparedness plan

4. Implement surveillance

5. Respond rapidly and effectively

Epidemic Preparedness and Response Committee - I

• Who should be on the committee ?• Technical• Political• Practical

• What are the tasks of the committee?• Before the epidemic• During the epidemic• After the epidemic

Epidemic Preparedness and Response Committee II

• Before the epidemic !• Set priorities• Write the epidemic preparedness and

response plan• Define prevention and control strategies

(versatility, adaptability)• Assign specific responsibilities for

surveillance, preparedness and response• Identify and mobilise resources

Epidemic Preparedness and Response Committee IIa

• Identify and mobilise resources

• HUMAN

• FINANCIAL

• PRACTICAL

Priority Setting - I

• What are the major epidemic prone diseases ?

• What is the risk of an epidemic ?• time since last outbreak,

• frequency of previous outbreaks

• recent disease trends

• What would be the likely impact of an epidemic ?• Potential number of cases

• Potential deaths

• Likelihood of spread

• Control measures ?• Are effective and affordable measures available ?

• Resources ?• Do we have adequate resources ?

Priority setting - II

Epidemic Risk Impact Control Resourcesprone disease measures

Cholera

Meningitis

Measles

JE

Malaria

Viral HF

High High

Low

Low

Low Low

High

High

Low

High

Low

Low

X

XX

Epidemic Preparedness and Response Plan - I

• List the priority diseases

• Define the surveillance, preparedness and

response measures to be implemented

• Identify responsibilities (who does what)

• Identify co-ordination mechanisms (leadership)

• Specify resources available for preparedness and

response (budget)

• What should be done ?

• Who should do it ?

• What resources or supplies will be required ?

Epidemic Preparedness and Response Plan - II

Surveillance - I

Health Care System Public Health Authority

Case

DetectionConfirm

DecisionControl

Measures

Investigation

Response

Report

OUTBREAK

Surveillance - II

Support function• advocacy for training• supervision• resource• standards/guidelines

Epidemic Preparedness and Response Committee - II

• During the epidemic !• Implement the plan• Rapid and coordinated response• Implement prevention and control strategies• Identify and mobilise resources

Rapid Response - I

• Early epidemic control team meeting

• Early assessment of the potential scale of the outbreak

• Co-ordinated investigation and implementation of control measures

• Public information– Health education

– Media strategy

Outbreakinvestigation

Laboratory

Support servicesand

logistics

MediaControl measures

Reports

PublicAuthorities

Environment

Epidemic response

committee

Epidemic Preparedness and Response Committee - III

• After the epidemic !• Evaluate the preparedness and the response • Review and update the plan• Modify prevention and control strategies• Identify and mobilise resources• Anticipate new outbreaks• Strengthen surveillance

PREPAREDNESS OUTBREAK CONTROL

Detect & Confirm

Investigate

Analyse

Respond

Evaluate

Predict & Prevent

Treat

Control

CommitteePriorities

PlanCo-ordination

ResponsibilitiesResourcesSuppliesTraining

SurveillanceRapid Response

Preparedness planning in different settings

• Hospital

• Local

• Disease-specific

• National

• International

Be

Prepared !