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FROM SARS TO BIO ATTACK: DEVELOPING A COORDINATED RESPONSE TO THE UNEXPECTED -- THE ROLE OF AN INTERNET BASED EARLY WARNING SYSTEM A.K.A. “THE INFORMAL SECTOR”. Marjorie P. Pollack, MD Associate Editor Epidemiology & Surveillance Moderator
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FROM SARS TO BIO ATTACK: DEVELOPING A COORDINATED RESPONSE TO THE UNEXPECTED -- THE ROLE OF AN INTERNET BASED EARLY WARNING SYSTEM A.K.A. “THE INFORMAL SECTOR”
Marjorie P. Pollack, MD
Associate Editor
Epidemiology & Surveillance Moderator
ProMED-mail, International Society for Infectious Diseases
<http://www.promedmail.org>
Source: ProMED-mail
http://www.promedmail.org
INFORMATION SOURCES USED BY WHO
Global Public Health Information Network
Source: WHO Ray Arthur Presentation ICEID 26 Mar 2002
Date: 10 Feb 2003
From: Stephen O. Cunnion, MD, PhD, MPH
International Consultants in Health, Inc
Member ASTM&H, ISTM
This morning I received this e-mail and then searched your archives
and found nothing that pertained to it. Does anyone know anything
about this problem?
"Have you heard of an epidemic in Guangzhou? An acquaintance of mine from a teacher's chat room lives there and reports that the hospitals there have been closed and people are dying."
Source: ProMED-mail archives -- edited
Date: 10 Feb 2003
Moderator comment:
Source: ProMED-mail archives -- edited
Date: Fri 21 Feb 2003
Source: British Medical Journal, 326, 416, Sat 22 Feb 2003 [edited]
<http://bmj.com/cgi/content/full/326/7386/416?etoc>
Pneumonia in Guangdong Province
-----------------------
The past 2 weeks have seen the province of Guangdong in southern China become victim to a serious pneumonia epidemic that seized its people with fear and caused major temporary economic damage, but that eventually turned out to have relatively slight medical impact. By last week, there had been 8 deaths.
However, considerable anxiety was created by an "epidemic of rumours." During the first week of February 2003 the public became aware of a mysterious respiratory illness which apparently had a very high mortality and caused death within hours. Symptoms included cough, fever, and breathing difficulty.
Source: ProMED-mail archives -- edited
Rumours abounded about the source of the infection…... People spread their fears and new-found information by telephone, mobile phone, text messages, email, and word of mouth. In the absence of public statements and official information the media communicated very little.
The rumour spread that many of the victims of the illness were hospital staff and that a number of them had died. As a result outpatient departments almost emptied.
It was not until Tue 11 Feb 2003 that an official statement was made by the Guangdong Department of Health. In the interim it had been very difficult for doctors and other health professionals to respond to the barrage of inquiries. The officials announced that the first case had occurred in November 2002, but as it was common for influenza-like infections to afflict the community in the winter months, there had been no undue concern.
Source: ProMED-mail archives -- edited
Date: 21 Feb 2003
Moderator comment:
[This article mentions a total of 345 cases in 8 cities throughout Guangdong with an associated 7 deaths…. What this article also mentions is the power of rumor-mongering that goes along with "unknown" etiology outbreaks. The statement "In the absence of public statements and official information the media communicated very little" may refer to the local media, but on the international level, the media were rife with articles on the outbreak, many of which would be better characterized as rumor mongering than real information exchange. This is a reminder of the need for official sources to report information on outbreaks and findings of outbreak investigations sooner rather than later. In today's environment, with increased telecommunications worldwide, combined with heightened concerns about bioterrorism, news of disease outbreaks travels much faster and more widely than in the past. - Mod.MPP]
Source: ProMED-mail archives -- edited
Source: ProMED-mail archives
Severe Acute Respiratory Syndrome: The U.S. Experience
February 10
--A report posted on ProMED describes a problem of pneumonia in China’s Guangdong Province
--CDC receives a call from a U.S. medical missionary who described reports of 400 deaths due to “pneumonic plague” in Guangdong; CDC contacts colleagues at WHO
March 5-11
-- CDC learns of spread of the disease to large numbers of HCWs in Hong Kong and Vietnam following alert to WHO from Dr. Urbani
March 12
-- WHO issues global alert about cases of severe atypical pneumonia in Hong Kong and Vietnam
Source: Presentation by James M. Hughes, M.D. Director, National Center for Infectious Diseases Director, National Center for Infectious Diseases Centers for Disease Control and Prevention Centers for Disease Control and Prevention, Global SARS conference 17 Jun 2003
Source: ProMED-mail archives
Source: ProMED-mail archives
Source: WHO/CSR <http://www.who.int/csr/sars/epicurve/epiindex/en/index1.html>
Source: WHO/CSR <http://www.who.int/csr/sars/epicurve/epiindex/en/index2.html>
We live in a global village
No single institution has the complete capacity to address all needs and cover all bases with respect to disease surveillance
Early alerts important and valuable -- prevents rumors, speculations
Encourages reporting on the part of partners
