A workshop on Public Health Safety and

1
A workshop on Public Health Safety and Emergency
Response Preparedness and Response To
Bioterrorism in Korea ?????????? 17-18 May 2006,
Beijing
Division of Preparedness and Response to
Bioterrorism ??CDC??????? KCDC/MOHW
2
Background ??

• Anthrax letter outbreak since 11th September
  2001
• 2001?9?11??????
• Establishment of Strategy on bioterror in Nov
  2001
• 2001?11?????????
• EstablishmentOperation of system on duty at
  emergency
• ?????????????
• Stockpiling of antibiotics, vaccine, equipment
  and facilities
• ??????????????
• Dual-Use surveillance system for early detection
• ????????????
• Laboratory Diagnosis System
• ???????
• Reinforcement of EducationTraining
• ??????

3
Preparedness Response to Bioterrorism in
Korea?????????
4
Capacity Building????

• Strengthening of organization and Professional
  manpower
• ???????
• Construction of Counter terror Intelligence
  Integration Center
• ???????????
• Construction of Division of Preparedness and
  Response to Bioterrorism, KCDC in Dec. 2003
• ??CDC??????????(2003.12)
• ConstructionOperation of Bioterrorism Task Force
  Team in MOHW, KCDC, Province(16), Public Health
  Center(248)
• ?????/CDC???????????????16???248???????

5
National Bioterror Headquarter ??????
6
Bioterrorism TFT in Ministry of Health and
Welfare ????????
7
Bioterrorism TFT in KCDC CDC?????
8
Bioterrorism TFT in ProvinceDistrict ?-???????
9
First Response Team?????
10
Role of First Responders??????????

• Police??
• Guard general population
• ??????
• Investigation and Searching out a criminal
• ???????
• Fire??
• Transfer Patients and specimen
• ???????
• Disinfection of Environment
• ????
• Public Health????
• Management of patientsexposures
• ???????
• Examination by rapid detection test kit
• ?????????

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Capacity Building????

• Amendment of law related to bioterrorism?????????
• Definition of Bioterrorism
• ???????
• Communicable diseases by Bio-terrrorism can be
  described as communicable diseases outbreaks by
  the use of a microorganism with the deliberated
  intention to being caused a infection in order to
  achieve certain goals
• ?????????????????,???????,???????????????
• Major Communicable Diseases by Bioterrorism
  report immediately
• ??????????????
• Disease under Control Law 5 classes 63
  diseases ????????????5?63???
• Plague(Class 1), Anthrax(Class 3), Smallpox,
  Botulism, VHF(Class 4) ??(1?),??(3?),??????????VHF
  (4?)
• Examination, conservation and control on
  Communicable Disease Pathogen
• ???????????????
• Hospital, Quarantine station,
  KFDA, Natl Institute of Animal Science
  Quarantine,
• Natl Plant Quarantine
  station???????KFDA??????????????
• Reports of name pathogen,
  isolated sample and isolated dates????????????????
  ??
• Establishing of BWC Implementation law
• BWC??????

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Capacity Building????

• Study and research on bioterror
• ????????
• Development for practical use
• ???????
• Vaccine and antitoxin
• ???????
• New diagnosis method
• ??????
• Multiple rapid detection test kit
• ?????????
• Study on Policy Development
• ????
• Scenario for response to bioterrorism
• ???????????
• Effective operation method of surveillance system
• ???????????

13
Capacity Building????

• Training Education????
• Education for First Responders(Police, Fire,
  Public Health)?????????
• Training course in KCDC CDC???
• Education Program for the first responders at
  province level ????????????
• Development Dissemination of Educational
  materials
• ?????????
• Education for reporters of Emergency Syndromic
  Surveillance System
• ???????????????
• Exercise for response to bioterrorism ????
• Anthrax Exercise(Silent Storm) March 25,
  2005
• 2005?3?25?????(?????)

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Capacity Building????

• Establishment of website????
• Public health centers daily report of Bioterror
  suspicious case
• ?????????????????
• Hospitals ??
• - Emergency dept daily report based on
  syndromic
  surveillance
• ?????????????
• - Infectious medicine dept when suspicious
  outbreak
  occur
• ???????????
• Provide first responders and general population
  with bioterror information and news
• ????????????????????????

15
Capacity Building????
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Capacity Building????

• International Cooperation and Collaboration????
• International Conference on bioterrorism
  preparedness and response in 2004, 2005
• 2004?2005???????????
• Collaboration with WHO, USA(CDC), JAPAN(NIID)
• ?WHO???CDC???NIID??
• Participation in WHO, APEC CTTF, SEARCCT, BWC
  meeting
• ??WHO?APEC CTTF?SEARCCT?BWC??

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Preparedness Response to Bioterrorism in
Korea????????
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Surveillance System????

• Dual-Use Surveillance System
• ?????????
• Emergency Syndromic Surveillance System
• ??????????
• Enhanced Emergency Surveillance System during
  special events
• ??????????????????
• Infectious Disease Specialist Network
• ??????

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Emergency Syndromic Surveillance
System ??????????

• Definition??
• to monitor unusual disease clusters based on
  sets of pre-diagnosis clinical signs, symptoms,
  or conditions that collectively may be
  indicative of a specific disease
• ????????????????????????????,??????????

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Emergency Syndromic Surveillance System
??????????

• Objectives??
• By closely monitoring the syndrome that are
  suspected of bioterrorism, possible
  disease spread due to bioterrorists attacks can
  be prevented
• ?????????????,?????????????????????????
• The prevalence of water and food borne diarrhea
  diseases, and respiratory infectious diseases
  like influenza is promptly recognized for the
  quick response.
• ????????????????????????,??????
• Reporting web based http//bioterrorism.cdc.go.k
  r
• ????
• Organization 125 hospitals (Emergency Dept.)
• ??125???(???)
• Experts Committee have meeting every semester
• ??????????

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Emergency Syndromic Surveillance
Systemhttp//bioterrorism.cdc.go.kr??????????
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The reportable diseases and patient ??????????
Reportable syndrome ??????? Diseases under surveillance??????? Diseases under surveillance???????
Reportable syndrome ??????? Bioterror infectious disease???????? Common infectious disease ?????
Acute skin rash syndrome ???? Smallpox?? -
Acute neurologic syndrome?????? Botulism?????? -
Acute hemorrhagic syndrome????? Viral Hemorrhagic Fever ?????? -
Acute respiratory syndrome??????? Anthrax, Plague??,?? Influenza, SARS??,??
Acute diarrheal syndrome???? - water and food borne infectious diseases like food poisoning, typhoid, Shigellosis etc ??????????,??????????????
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Reporting system????
             
             
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Reported Cases of Emergency Syndromic
Surveillance(02-05)02-05????????????????
unit case???
Year? Acute skin rash syndrome ???? Acute neurologic syndrome?????? Acute hemorrhagic syndrome ????? Acute diarrhea syndrome outbreak/(sporadic) ??????/?? Acute respiratory syndrome /(severe case) ???????/????
total 71 9 61 304(47,719) 31,811(13)
2002 30 2 26 84(3,608) 7,027(0)
2003 4 7 5 75(2,484) 6,862(0)
2004 17 0 16 109(15,127) 8,783(9)
2005 20 0 14 36(26,500) 9,139(4)
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Surveillance System????

• Dual-Use Surveillance System
• ???????
• Emergency Syndromic Surveillance System
• ??????????
• Enhanced Emergency Surveillance System during
  special events
• ?????????????
• Infectious Disease Specialist Network
• ??????

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Enhanced Emergency Syndromic Surveillance
System ?????????????

• Definition??
• Enhanced Syndromic Surveillance System is
  operated through related area during special
  events such as ADB meeting, APEC meeting etc.
• ????????????????????,?ADB???
• APEC???,???????
• Purpose ??
• Early detection and response to suspicious
  outbreaks in the related area during special
  events
• ?????????????????????????

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Enhanced Emergency Syndromic Surveillance
System?????????????

• Expansion of Reportable organizataion
• ???????
• To add emergency departments in events area
• ???????????
• Expansion of Reportable syndrome
• ??????? acute gastro-intestinal syndrome, acute
  respiratory syndrome, acute pneumonia, acute
  skin-rash syndrome, acute fever syndrome,
  septic/non-traumatic shock
• ?????????????????????????????/??????

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Operation of EESS ????????????????

• 03 Daegu Universiade
• 04 Jeju ADB Meeting
• 05 APEC in Jeju 6 May 14 June 2005
• 05 APEC in Kyeong Ju 22Aug28Sep2005
• 05 APEC in Busan 28 Oct 4 Dec 2005

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Surveillance System????

• Dual-Use Surveillance System
• ???????
• Emergency Syndromic Surveillance System
• ??????????
• Enhanced Emergency Surveillance System during
  special events
• ?????????????
• Infectious Disease Specialist Network
• ??????

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• Infectious Disease Specialist Network
• ??????

• Definition??
• provide healthcare professionals with information
  when a bioterrorists activities or emerging and
  re-emerging diseases are suspected in order to
  prevent epidemics
• ????????????????????????????,???????????,??????
• provide information, news, materials, and
  overseas status about infectious disease
• ???????????????????

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Infectious Disease Specialist Network??????

• Reporting organization
• ????
• 50 hospitals which have Department of
  infectious medicine and infectious pediatric
• 50????????????????
• Reportable patients
• ????
• Patients suspected of bioterror
• ????????
• - anthrax, smallpox, botulism, plague, viral
• hemorrhagic fever(VHF)
• ??????????????????????(VHF)
• Patients suspected of Diarrhea (mass)
• ??????
• Advisory committee 13 Experts consult about
  a reported
  case
• ????????????13?????

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Reporting System????
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Infectious Disease Specialist Networkhttp//biote
rrorism.cdc.go.kr????????
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Reported cases of Infectious Disease Specialist
Network(02-05)02-05????????????
unit person ???
?? ?
Year? Suspected anthrax ???? Suspected plague ???? Suspected smallpox ???? Suspected botulism ???????? Suspected VHF ???????? Acute diarrhea syndrome ????
total 0 0 0 7 2 169
2002 0 0 0 1 2 128
2003 0 0 0 3 0 18
2004 0 0 0 3 0 0
2005 0 0 0 0 0 23
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Preparedness Response to Bioterrorism in
Korea????????
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Purpose ??

• Promote the readiness of national public health
  center labs and hospital labs for a swift
  diagnostic system
• ??????????????????????????????
• Construct laboratory network
• ???????
• Share information among related laboratory
  experts
• ???????????

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Laboratory System?????
38
Preparedness Response to Bioterrorism in
Korea????????
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Stockpile????

• Antibiotics and Vaccine
• ??????
• Equipments
• ??
• Facilities
• ?????
• Rapid Detection Test Kit
• ???????

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Antibiotics and vaccine??????

• Ciprofloxacine
• Doxycycline
• Smallpox vaccine and bifurcated needle

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Equipments??

• Level A Personal Protective Equipment
• A????????
• Level C Personal Protective Equipment
• C????????
• Decon shower
• ????
• Pressure Test Kit
• ?????
• Fit Test Kit
• ?????

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Facilities?????
Laboratory in KCDC CDC???
Mobile command vehicle ?????
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Rapid Detection Test Kit???????
Bioterror pathogen and toxin test
Kit ?????????????
Anthrax Spore test Kit ???????
Botulinum toxin test Kit ?????????
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Absence of Evidence is not Evidence of Absence
Thank you