Sunday, February 16, 2014

The Global Reach Of Infectious Disease


Photo Credit- CDC


# 8303


This week we’ve seen two of the world’s most prestigious public health organizations (CDC & WHO) publicly express concerns over the increasing dangers of global disease spread – including, but certainly not limited to – pandemic influenza. 


On Wednesday, in WHO: IHR & Global Health Security, we looked at the large number of member states which have yet to meet the core surveillance and response requirements of the International Health Regulations that went into force in 2007.


WHO IHR Infographic


On Friday, in CIDRAP On The Global Health Security Agenda, we looked at a 26 nation initiative to improve global health surveillance & emergency response in an age of rising infectious diseases.  The rationale for which is explained on the CDC’s Global Health Website at:


Why Global Health Security Matters

Disease Threats Can Spread Faster and More Unpredictably Than Ever Before


A disease threat anywhere can mean a threat everywhere. It is defined by

  • the emergence and spread of new microbes;
  • globalization of travel and trade;
  • rise of drug resistance; and
  • potential use of laboratories to make and release—intentionally or not—dangerous microbes.

 (Continue . . .)


These are hardly new concerns for either agency, as both have worked for decades to prevent the spread of disease around the world. But over the past decade there has come a greater awareness of the ability of once rare, and geographically remote, infectious diseases to travel in a matter of hours to virtually any part of the globe.

A partial list of recent global health threats we’ve discussed previously includes:



To this short list you can add Pandemic H1N1 in 2009, the emergence of MERS-CoV from the Arabian Peninsula (see WHO MERS-CoV Summary Update #13, the continual spread of H7N9 and H5N1 avian flu viruses (see The Expanding Array Of Novel Flu Strains), Polio in the Middle East and Africa, contaminated food or drugs, XDR-TB, and of course the one(s) we don’t even know about yet . . Virus X.


This rationally paranoid listing of disease threats is backed up by a recent Assessment by the Director of National Security (see DNI: An Influenza Pandemic As A National Security Threat) that finds the global spread of infectious diseases – along with cyber attacks, terrorism, extreme weather events, WMDs, food and water insecurity, and global economic concerns.- constitutes a genuine threat to national security.


Although the specter of pandemic influenza and  bioterrorism get the most attention in the media, already each year thousands of people in the United States (and around the world) are sickened or die from `imported’ diseases like WNV, HIV/AIDS, Carbapenem-resistant  bacteria, and TB


History has shown, that once a disease takes flight, it is notoriously difficult to reign in.  Hence the need to tackle infectious diseases where they emerge, not once they arrive on our shores.


While you and I cannot do much about disease threats around the world (except for supporting elected representatives who vote to fund public health, and contributing to NGOs who fight the battles every day), there are things you can do to prepare for the day when – inevitably, and despite the best efforts of public health agencies to prevent it – the next pandemic threat emerges.


We’re not talking building a `doomsday bunker’, or stockpiling a 2-year supply of N95 masks and Tyvek suits, but rather taking reasonable steps to prepare your family, business, and community against what is perceived by many as being all but inevitable; another pandemic.


Pandemics, while rare, are just one of scores of possible disaster scenarios that one can find themselves suddenly thrust into. When you add in the risks from earthquakes, hurricanes, tornadoes, floods, blizzards, and other – even more common – emergencies, it makes sense to maintain a general level of preparedness against `all threats’.


Every family needs an appropriate disaster plan, just as everyone should have a good first aid kit, a `bug-out bag’, and sufficient emergency supplies to last a bare minimum of 72 hours.


Most preparedness experts would recommend that people should consider maintaining a 2-week supply of supplies in their home.  A topic I address in When 72 Hours Isn’t Enough.

And businesses, if they hope to survive a pandemic (or any other disaster), need a comprehensive business continuity plan. Although there are many good resources on the web to get you started, a couple of places to begin are The Business Continuity Daily and Cambridge Risk Perspectives, both of which provide daily reviews of current threats and advice on preparedness.


One of the nation’s leaders in pandemic and disaster planning is Public Health - Seattle & King County.  In 2008 they produced a 20 minute film called Business Not As Usual, designed to help introduce businesses to the core concepts of pandemic planning.

Frankly, this video should be required viewing for every businesses owner, manager, and employee.

image maintains a pandemic planning and preparedness page, where the following appears.



Their advice (and this is for before a pandemic threat becomes imminent).



Given the speed at which a well-adapted virus could spread globally (days or weeks), the time to practice and prepare for the next pandemic is now, not after an outbreak has begun. Given the seriousness with which U.S. and International  agencies and organizations obviously give the pandemic threat, it only makes sense to take it seriously yourself.


For more on pandemic preparedness, you may wish to revisit:

NPM13: Pandemic Planning Assumptions
The Pandemic Preparedness Messaging Dilemma
Pandemic Planning For Business
CDC: Pandemic Planning Tips For Public Health Officials
H7N9 Preparedness: What The CDC Is Doing