MEXICO BEFORE AN INFLUENZA PANDEMIC BOGOTÁ, COLOMBIA APRIL, 2006 THE NEXT INFLUENZA PANDEMIC: A RESPONSE BY THE MEXICAN STATE Dr. Yessica Chaparro REGIONAL.

MEXICO BEFORE ANINFLUENZA PANDEMIC

BOGOTÁ, COLOMBIAAPRIL, 2006

THE NEXT INFLUENZA PANDEMIC:A RESPONSE BY THE MEXICAN STATE

Dr. Yessica Chaparro

REGIONAL MEETING ABOUT THE PREPAREDNESS AND RESPONSE OF THE HEALTH ATTENTION SERVICES TO AN INFLUENZA PANDEMIC


• Created in 2003

• Analysis definition,

coordination, monitoring and

evaluation of policies,

strategies and actions in

terms of Health Safety.

National Committee for Health SafetyNational Committee for Health Safety

Protect the health of the population from risks and damages originated by epidemiological emergencies and disasters


Strategic ComponentsStrategic Components

Flooding, hurricanes, earthquakes, volcanic eruptions, fires...

Intoxication with chemical substances, explosions, toxic substance spills, environmental contamination...

Intentional liberation of biological agents.…

Contamination, overpopulation, risks to patients or personnel….

Dengue, VON, malaria,

leptospirosis, influenza, ETAS, SARS...


OBJECTIVEOBJECTIVE

To protect the Mexican population from the To protect the Mexican population from the risk of an influenza pandemic through the risk of an influenza pandemic through the coordination of actions that allow the coordination of actions that allow the preparation of a rapid responsepreparation of a rapid response

National Plan for Preparation and Response to an Influenza Pandemic

Dynamic document under permanent evolution

Created by the Created by the National Committee for National Committee for Health SafetyHealth Safety

Second version currently under revision


PHASES PRE PANDEMIC PANDEMIC ALERT PANDEMIC1 2 3 4 5 6OMS

There are no new subtypesof the Influenzavirus in humanbeings

New subtypeof the virus inanimals withconsiderablerisk of humandisease

Cases of disease inhumans witha new subtypeof the viruswithouttransmissionfrom human to human

Smalloutbreaks ofthe disease.Transmissionlimited fromperson to person

Largeoutbreaks ofthe disease.Transmissionlimited fromperson toperson

Transmissionsustained by thedisease

PRE PANDEMIC PANDEMICMEXICO

Preparation activities at a National Level

Cases in Asia

Cases in twoContinents

exceptAmerica

Cases inAmerica

Cases inMexico

Stages of Stages of AlertAlert

National Plan for the Preparation and Response to an Influenza Pandemic

1

2 3 4 5


•Dissemination and social Dissemination and social mobilizationmobilization

•CoordinationCoordination

•Epidemiological vigilanceEpidemiological vigilance

•Medical AttentionMedical Attention

•Strategic reserveStrategic reserve

•Investigation and DevelopmentInvestigation and Development

National Plan for the Preparation and Response to an Influenza Pandemic

Lines of Lines of

ActionAction


Dissemination and Social MobilizationDissemination and Social Mobilization

• Risk Communication StrategyRisk Communication Strategy

• Media Campaign in PhasesMedia Campaign in Phases

• Dissemination to the Population and Health ProfessionalsDissemination to the Population and Health Professionals

• Sensibilization of Strategic Groups (Teachers, Parents, Unions, Sensibilization of Strategic Groups (Teachers, Parents, Unions, Businesspeople etc.)Businesspeople etc.)

• Training of Strategic Personnel (Armed Forces and Public Order, Training of Strategic Personnel (Armed Forces and Public Order, Airports, Ports, Borders, Tourism)Airports, Ports, Borders, Tourism)

Information on the Internet:Information on the Internet:

www.salud.gob.mxwww.salud.gob.mx

Telephone: Telephone: 0180001800


CoordinationCoordination

• Fundamental for a timely responseFundamental for a timely response

• Incorporation of all relevant areas through the National Incorporation of all relevant areas through the National Committee for Health SafetyCommittee for Health Safety

•Health SectorHealth Sector

• Inter sectorInter sector•State and Local LevelsState and Local Levels•InternationalInternational

International

FederalLevel

StateLevel

LocalLevel

FederalCommand

SESARed Cross

SEGOB SEDENA SEMAR SHCP SFP SEDESOL STPS SE SEP SCT SALUD SAGARPA SEMARNAT SRE SSP SECTUR


CoordinationCoordination

FEDERAL LEVEL

CIVIL SOCIETYHEALTH SECTOROTHER SECTORS

STATE LEVEL

CIVIL SOCIETYHEALTH SECTOROTHER SECTORS

LOCAL LEVEL

CIVIL SOCIETYHEALTH UNITSOPERATIONAL AREAS


CoordinationCoordination•InternationalInternational

• Ministry Reunion, Ottawa, Oct 2005Ministry Reunion, Ottawa, Oct 2005

• World Reunion on the Bird Flu and Pandemic, Geneva, Nov 2005World Reunion on the Bird Flu and Pandemic, Geneva, Nov 2005

• 6th. Ministerial Reunion of the Global Group on Health Safety 6th. Ministerial Reunion of the Global Group on Health Safety (G7+México), Rome, Nov. 2005(G7+México), Rome, Nov. 2005

• IPAPI Reunion, Washington, D.C., 2005IPAPI Reunion, Washington, D.C., 2005

• Workshop for Molding the Impact, San José, Costa Rica, 2005Workshop for Molding the Impact, San José, Costa Rica, 2005

• Sub regional Workshop for Preparing for an Influenza Pandemic, Sub regional Workshop for Preparing for an Influenza Pandemic, Panama, February 2006Panama, February 2006


Epidemiological VigilanceEpidemiological Vigilance

• Training of Health Training of Health PersonnelPersonnel

• Strengthening RoutineStrengthening RoutineVigilanceVigilance

• Continuous Monitoring (UIES)Continuous Monitoring (UIES)

• Animal Vigilance (SAGARPA)Animal Vigilance (SAGARPA)

• Diagnostic CapacityDiagnostic Capacity

•Consolidation of the National Network of LaboratoriesConsolidation of the National Network of Laboratories

• Strengthening Laboratories P3Strengthening Laboratories P3

• International AgreementsInternational Agreements


Preventive ActionsPreventive Actions

• Reduction of Social ContactReduction of Social Contact• Limit the movement of People and MerchandiseLimit the movement of People and Merchandise• Basic Hygiene measures (Washing hands, using masks)Basic Hygiene measures (Washing hands, using masks)

Main strategies for Pandemic control (Public Health Measures):Main strategies for Pandemic control (Public Health Measures):

• Triage schemeTriage scheme• Strengthening hospital attention capacityStrengthening hospital attention capacity• Protection measures for health personnelProtection measures for health personnel• Attention Protocols (Children and Adults)Attention Protocols (Children and Adults)• Management of RPBI/corpsesManagement of RPBI/corpses

Medical AttentionMedical Attention

Servicio médico forenseFallecido a consecuencia de un cuadro clínico sospechoso o confirmado de Influenza.

Compensación de enfermedad

crónica y complicaciones.

Unidad médica hospitalaria

fija o de campaña

Cuadro clínico de Influenza con complicaciones pulmonares y/o enfermedad crónica descompensada.

Sintomático y antivirales

Centro de Atención y

Aislamiento

Cuadro clínico de Influenza sin complicaciones pulmonares y/o enfermedad crónica controlada.

Sintomático y medidas de

bioseguridad

Aislamiento domiciliario

estricto

Sintomatología sugestiva de influenza, sin complicaciones pulmonares y sin enfermedad crónica agregada.

Sintomático y medidas de bioseguridad

DomicilioSintomatología respiratoria no compatible con influenza.

Medidas de bioseguridad

DomicilioSano, sin sintomatología respiratoria.

TratamientoReferenciaTipo de paciente

• Identification of the bird influenza stumps that are circlingIdentification of the bird influenza stumps that are circling• Permanent bird vaccination campaignsPermanent bird vaccination campaigns• Bird influenza outbreak control in farmsBird influenza outbreak control in farms

Strategies to control outbreaks in birds:Strategies to control outbreaks in birds:


Hospital AttentionHospital Attention

Servicio médico forenseFallecido a consecuencia de un cuadro clínico sospechoso o confirmado de Influenza.

Compensación de enfermedad

crónica y complicaciones.

Unidad médica hospitalaria

fija o de campaña

Cuadro clínico de Influenza con complicaciones pulmonares y/o enfermedad crónica descompensada.

Sintomático y antivirales

Centro de Atención y

Aislamiento

Cuadro clínico de Influenza sin complicaciones pulmonares y/o enfermedad crónica controlada.

Sintomático y medidas de

bioseguridad

Aislamiento domiciliario

estricto

Sintomatología sugestiva de influenza, sin complicaciones pulmonares y sin enfermedad crónica agregada.

Sintomático y medidas de bioseguridad

DomicilioSintomatología respiratoria no compatible con influenza.

Medidas de bioseguridad

DomicilioSano, sin sintomatología respiratoria.

TratamientoReferenciaTipo de paciente

“Hospital Reconversion”

MINICLINIC

MINICLINIC

SECURITYPERIMETER


Strategic ReservesStrategic Reserves

• Reserve for the initial response:Reserve for the initial response:

• Antiviral (Oseltamivir)Antiviral (Oseltamivir)• Post contact prophylaxis, treatmentPost contact prophylaxis, treatment• Priority schemePriority scheme

•Antibiotics for managing complicationsAntibiotics for managing complications•Protection equipment for health personnelProtection equipment for health personnel•Laboratory equipmentLaboratory equipment•Training materialTraining material• Vaccine against H5N1Vaccine against H5N1

• Investment requirements in States and MunicipalitiesInvestment requirements in States and Municipalities• Consideration of administrative aspectsConsideration of administrative aspects


Anti Influenza VaccineAnti Influenza Vaccine

Vaccine against seasonal influenza in humansVaccine against seasonal influenza in humans Development of a prevention cultureDevelopment of a prevention culture Avoid genetic exchange between bird and Avoid genetic exchange between bird and human human virusesviruses

Establishment of international agreements to transfer technology Establishment of international agreements to transfer technology and training to personnel in Mexicoand training to personnel in Mexico

1St STAGE

VACCINE AGAINST

SEASONAL INFLUENZA

2nd STAGE

VACCINE AGAINST THE INFLUENZA PANDEMIC

VACCINE AGAINST

BIRD INFLUENZA

A (H5N1)


• Need to increase basic investigation, clinical and Need to increase basic investigation, clinical and epidemiological, for the development of technologies and epidemiological, for the development of technologies and national capacity in terms of:national capacity in terms of:

Investigation and DevelopmentInvestigation and Development

• AntiviralAntiviral• New techniques for the production of vaccinesNew techniques for the production of vaccines• Alternative treatmentsAlternative treatments• Mathematical modeling for simulating scenariosMathematical modeling for simulating scenarios

Participation of Higher Education Institutions


Steps to FollowSteps to Follow

• National simulation in a real scale and command post National simulation in a real scale and command post exercise in the second semester of 2006exercise in the second semester of 2006

“Escudo Centinela” ExerciseNational Exercise to evaluate the Response

capacity before an Influenza Pandemic


Steps to FollowSteps to Follow

• Plan operation at a state and local levelPlan operation at a state and local level

• New version of PNPRPI: First Semester 2006New version of PNPRPI: First Semester 2006

• Evaluation exercises at all levelsEvaluation exercises at all levels

• Coordination with Central America and the CaribbeanCoordination with Central America and the Caribbean

• Media campaign designed in phasesMedia campaign designed in phases


APRIL, 2006

THE NEXT INFLUENZA PANDEMIC: A RESPONSE by

THE MEXICAN STATE

www.dgepi.salud.gob.mx

MEXICO BEFORE AN INFLUENZA PANDEMIC BOGOTÁ, COLOMBIA APRIL, 2006 THE NEXT INFLUENZA PANDEMIC: A RESPONSE BY THE MEXICAN STATE Dr. Yessica Chaparro REGIONAL.

Documents

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influenza virus

health safetyincorporation

health safety g7

terms of health safety

national level cases