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Emerging infectious disease — An infectious disease that has newly appeared in a population or that has been known for some time but is rapidly increasing in incidence or geographic range. Last week’s Ebola Virus Disease (EVD) logarithmic chart update – 06 August 2015 post outlined an idea for creating a packet of specific responses to new disease outbreaks. It is apparent that neither the CDC nor WHO has such specific packets for new disease outbreaks. If such packets existed the West Africa Ebola Virus Disease (EVD) would have had an overnight response. On March 20, 2014 there was laboratory proof that Ebola disease was having an outbreak, in Liberia. By that date there were about one hundred cases and about forty deaths. That is enough to realize there was a serious problem, but it wasn’t until six months later when there were fifteen thousand cases that the then massive efforts needed for controlling it were having an impact.

What I am proposing with this outline is an emerging infectious disease outbreak checklist and handout packet. This packet is a way to have an effective response quickly. The initial stages of this plan could be implemented even before a specific event was known to be a disease outbreak, because the people who would be in the locality of the potential outbreak could be defined and contacted even before there was a known outbreak. The possibly relevant people need not know the CDC contact was potentially serious, because all that is needed at this early time is that the local people exist and have a basic knowledge of what will be required of them. When laboratory results were in, the packets could be put into final form and sent to these local contacts instantly.

When the relevant contact individuals are known worldwide they can be routinely checked every few months. That routine checkup would by slightly random, so they wouldn’t become unnecessarily alarmed at being contacted at an unusual time. This new contact could be little more than a routine printout of potential diseases of the area and requesting that a response be made that there was nothing like this at the moment. These routine information sheets could be sent out even while suspected tests were being performed in laboratories. Part of this routine check-in procedure would be to xerox a few copies to give one to the hospitals and local mayor. The idea here is not to alarm anyone, but simply to make certain that the relevant channels of communication are open and that the secondary channels are available.

The laboratory and hospital contacts list

This would be a database of all testing laboratories in the world where medical samples might be tested. The number of labs will be large, but they should be contacted routinely, and routinely asked if anything unusual is happening.

A second routine checklist would be of all hospitals and doctors of the world. They would be routinely contacted for unusual cases. Of course there would be gaps in information, but if the channels were known to be available, and accepted, then someone would eventually report a problem, and then the other contacts in the area could be questioned immediately, online, with a list of symptoms. When an outbreak seemed likely the preexisting pamphlets could be updated with corrected names for the disease and its unique symptoms and the most promising procedures for coping with it.

There are over a thousand languages, so it would be necessary to have established contacts for translating to all of these languages. There could be instantly available contacts for all major languages, and via these known people there could be contacts with the minor local language speakers. The basic symptoms of the infectious disease could be pre-printed, at least in digital form back at the CDC, and the qualities of the new disease tagged in at the last minute, before transmitting the packet to the local contact and printer. After the basic format was available for printing it could be translated by local people and sent back to the CDC.

Ebola symptoms and actions

A chart similar to this one, but with more legible text, and specific to the suspect disease should be widely distributed in the outbreak area within one day of laboratory confirmation.

Charts similar to the one above could be prepared right now for hundreds of diseases. After vetting by appropriate authorities, they could be translated into major languages, and once again vetted by doctors speaking those languages. These pre-planned information handouts for many diseases could be stored on computer and ready for instant printout at the needed locations. Radio and TV and online information packets with relevant information should also be pre-made and instantly available. This procedure would have a built-in feedback loop and the printouts would soon be refined to become ever clearer to local people, including the non-literate people.

Pre-response preparation is quicker to cope with an outbreak than post-event reassignment of otherwise occupied personnel and resources.

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