. . Pan American Health Organization Adapting Existing National Plans for new health emergencies Adapting Existing National Plans for new health emergencies - Cholera Cholera Dr Robert Lee Dr Robert Lee Emergency Preparedness and Disaster Relief Area
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Pan AmericanHealthOrganization
Adapting Existing National Plans for new health emergencies Adapting Existing National Plans for new health emergencies
-- CholeraCholera
Dr Robert LeeDr Robert Lee
Emergency Preparedness
and Disaster Relief Area
BackgroundBackground
�� All Caribbean Countries have:All Caribbean Countries have:
oo National Emergency PlansNational Emergency Plans
oo National Influenza Pandemic PlansNational Influenza Pandemic Plans
oo IHR PlansIHR Plans
�� All Caribbean Countries have:All Caribbean Countries have:
oo National Emergency PlansNational Emergency Plans
oo National Influenza Pandemic PlansNational Influenza Pandemic Plans
oo IHR PlansIHR Plans
Pan AmericanHealthOrganization
�� Foundations of public health control Foundations of public health control
�� Essential elements of a NCPEssential elements of a NCP
�� Foundations of public health control Foundations of public health control
�� Essential elements of a NCPEssential elements of a NCP
� Characterized by a sudden
onset of acute watery diarrhea
with(out) vomiting
� Transmitted by contaminated
water, food, dirty hands, vomit
and faeces
� Characterized by a sudden
onset of acute watery diarrhea
with(out) vomiting
� Transmitted by contaminated
water, food, dirty hands, vomit
and faeces
What is cholera?What is cholera?
Pan AmericanHealthOrganization
and faeces
� Extremely virulent, spreads
rapidly and can quickly (within
hours) lead to death from
severe dehydration
and faeces
� Extremely virulent, spreads
rapidly and can quickly (within
hours) lead to death from
severe dehydration
Recent EpidemicsRecent Epidemics
Pan AmericanHealthOrganization
Source: Harris, B.J. et al.
Lancet, Vol 376, Dec 11, 2010
Developing a health emergency
plan: first steps
Developing a health emergency
plan: first steps
� Establish a planning committee with reps from all relevant
sectors
� Agree (provisionally) on roles & responsibilities
� Designate who is responsible for what: lead agencies,
individuals, spokespersons!
� Establish a planning committee with reps from all relevant
sectors
� Agree (provisionally) on roles & responsibilities
� Designate who is responsible for what: lead agencies,
individuals, spokespersons!
Pan AmericanHealthOrganization
individuals, spokespersons!
� Set deadlines and define baselines
� Identify resources (financial and human)
� Determine gaps and constraints
individuals, spokespersons!
� Set deadlines and define baselines
� Identify resources (financial and human)
� Determine gaps and constraints
Elements of a national health emergency planElements of a national health emergency plan
Pan AmericanHealthOrganization
Foundations of Prevention & ControlFoundations of Prevention & Control
� Treatment: oral rehydration salts (ORS)
� Prevention: improvement of and access to safe
water and sanitation
� Treatment: oral rehydration salts (ORS)
� Prevention: improvement of and access to safe
water and sanitation
Pan AmericanHealthOrganization
� Preparedness: community mobilisation
� Intersectoral coordination
� Preparedness: community mobilisation
� Intersectoral coordination
Perspectives to aid planning for an
outbreak
Perspectives to aid planning for an
outbreak
In most cholera outbreaks, roughly:
� 75% of infected individuals do not develop symptoms
� Of those who do, roughly 80% of cases are mild/moderate
In most cholera outbreaks, roughly:
� 75% of infected individuals do not develop symptoms
� Of those who do, roughly 80% of cases are mild/moderate
Pan AmericanHealthOrganization
� Of those who do, roughly 80% of cases are mild/moderate
� 10 - 20% are severe
� 1% benchmark for case fatality rates is rarely met
� Of those who do, roughly 80% of cases are mild/moderate
� 10 - 20% are severe
� 1% benchmark for case fatality rates is rarely met