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PubMed2005

Hospital preparedness and management of patients affected by viral haemorrhagic fever or smallpox at the Lazzaro Spallanzani Institute, Italy.

The US cases of anthrax in 2001 and the recent severe acute respiratory syndrome outbreak have heightened the need for preparedness and response to naturally emerging and re-emerging infections or deliberately released biological agents. This report describes the response model of the Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani (INMI), Rome, Italy for managing patients suspected of or affected by smallpox or viral haemorrhagic fever (VHF) either in the context of an intentional release or natural occurrence. The INMI is Italy's leading hospital in its preparedness and response plan to bioterrorism-related infectious agents. All single and double rooms of INMI are equipped with negative air pressure, sealed doors, high efficiency particulate air (HEPA) filters and a fully-equipped anteroom; moreover, a dedicated high isolation unit with a laboratory next door for the initial diagnostic assays is available for admission of sporadic patients requiring high isolation. For patient transportation, two fully equipped ambulances and two stretcher isolators with a negative pressure section are available. Biomolecular and traditional diagnostic assays are currently performed in the biosafety level 3/4 (BSL 3/4) laboratories. Continuing education and training of hospital staff, consistent application of infection control practices, and availability of adequate personnel protective equipment are additional resources implemented for the care of highly infectious patients and to maintain the readiness of an appropriately trained workforce to handle large scale outbreaks.

Disease Management↗
PubMed2005

[Smallpox preparedness in Denmark].

Although the likelihood of a deliberate release is considered to be minor, smallpox virus poses a worldwide terrorism security risk because it (1) can easily be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential to create a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. Consequently, Statens Serum Institute and the National Board of Health have developed a Danish smallpox preparedness plan. This article discusses critical aspects of the plan, including risk analysis and a multi-tiered action plan, vaccination, analysis of clinical specimens, the establishment of active surveillance teams and generic contingency elements.

Bioterrorism↗
PubMed2005

Registration of food facilities under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002. Final rule.

The Food and Drug Administration (FDA) is issuing a final regulation that confirms the interim final rule entitled "Registration of Food Facilities Under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002" (68 FR 58894, October 10, 2003 (interim final rule) as corrected by a technical amendment (69 FR 29428, May 24, 2004), and responds to comments submitted in response to the request for comments in the interim final rule. This final rule affirms the interim final rule's requirement that domestic and foreign facilities that manufacture/process, pack, or hold food for human or animal consumption in the United States be registered with FDA by December 12, 2003. The interim final rule implemented the Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (the Bioterrorism Act), which requires domestic and foreign facilities to be registered with FDA by December 12, 2003. This final rule does not make any changes to the regulatory requirements established by the interim final rule.

Bioterrorism↗
PubMedDate not supplied

Fortune favours the prepared mind: a national perspective on pandemic preparedness.

The rapid spread of avian influenza H5N1 in Asia in late 2003 has moved the world to a new state of pandemic alert. The risk of further human cases will persist, as will opportunities for a pandemic virus to emerge. Therefore, Canada has taken a number of steps to strengthen national pandemic preparedness. Coordination has been fostered through the development of a national pandemic preparedness plan and ongoing development of systems and processes for national health emergency management. Specific areas of advancement include: enhancement of rapid surveillance and communication capacity, the pandemic vaccine strategy, acquisition of an antiviral stockpile, research prioritization, international collaboration, and an international meeting of Ministers of Health (October 2005) to enhance global cooperation and coordination in advance of a possible influenza pandemic. Key next steps include: publication of the 2005 edition of the Canadian Pandemic Influenza Plan; conducting emergency exercises to help strengthen planning at all levels and across health care, emergency management and NGO sectors; developing H5N1 vaccine and clinical trials; evaluating the need to supplement national antiviral stockpile; and undertaking public and key stakeholder consultations to provide further input into planning strategies and activities.

Animals↗
PubMed2005

[The preparedness plan for influenza pandemic].

Influenza A viruses periodically cause worldwide epidemics, or pandemics, with high rates of illness and death. A pandemic can occur at any time, with the potential to cause serious illness, death and social and economic disruption throughout the world. Historic evidence suggests that pandemics occurred three to four times per century. In the last century there were three influenza pandemics. The circumstances still exist for a new influenza virus with pandemic potential to emerge and spread. The unpredictability of the timing of the next pandemic is underlined by the occurrence of several large outbreaks of highly pathogenic avian influenza since the early 1980s. In 1999, the World Health Organization published the Influenza pandemic plan. The role of WHO and guidelines for national and regional planning. And in 2005, WHO revised the global influenza preparedness plan for new national measures before and during pandemics. This document outlines briefly the Korean Centers for Disease Control's plan for responding to an influenza pandemic. According to the new pandemic phases of WHO, we set up the 4 national levels of preparedness and made guidelines for preventing and control the epidemics in each phase. And also we described the future plans to antiviral stockpiles and pandemic vaccine development.

Disease Outbreaks↗
PubMed2006

Introducing a senior course on catastrophe preparedness into the dental school curriculum.

This article describes an integrated fourth-year course in catastrophe preparedness for students at the New York University College of Dentistry (NYUCD). The curriculum is built around the competencies proposed in "Predoctoral Dental School Curriculum for Catastrophe Preparedness," published in the August 2004 Journal of Dental Education. We highlight our experience developing the program and offer suggestions to other dental schools considering adding bioterrorism studies to their curriculum.

Bioterrorism↗
PubMedDate not supplied

Expanding educational opportunities in disaster response and emergency preparedness for nurses.

The past few years have witnessed a dramatic increase in the number of large-scale disaster events and the ubiquitous threat of weapons of mass destruction. These events have heightened recognition of the role of the nurse in disaster management and response. Enhanced capacity to respond to disasters and other public health emergencies will require a nursing workforce that is clinically experienced and possesses the knowledge and skills necessary to respond with confidence and authority. This article reports on how American schools of nursing have begun to address the challenge of workforce development and nurse preparedness. The University of Rochester Leadership in Health Care Systems in Disaster Response and Emergency Preparedness Program is described in detail.

Bioterrorism↗
PubMed2006

Applied medical & care compunetics to public health disease surveillance and management: Leveraging external data sources--a key to public health preparedness.

In today's global community the ability to prepare for a disease outbreak in order to mitigate the public health, social, and economic impacts on a community depends upon data to support the decision and response process. Data can come from a variety of sources. These sources not only include the medical and health care community, but also geographic, demographic, and socio-economic data. The ability to capture and utilize the data effectively from these types of data sources can mean the difference between a manageable disease outbreak that represents little or no threat to a community and one that causes a significant social and economic impact. As the health profession expands the applied use of information technology within the medical and health care communities, opportunities are created to expand the use of new data sources to support information based decisions. Information that can be used to provide early warning for disease outbreaks both naturally occurring or through a bioterrorist event; information that can be used to plan, analyze and respond to a disease event; information that can support a community's preparedness activities in order to minimize a public health event. This chapter illustrates how applied compunetics can be used to support health care as the public health professional responds to, and manages, naturally occurring diseases as well as emerging new disease threats. An electronic health environment (EHE) vision is presented that capitalizes on the use of a variety of environmental, medical, and health care data to support disease early warning, reporting, case and outbreak management and community preparedness.

Community Health Planning↗
PubMed1996

Non-clinical roles of Army family physicians in their first post-residency assignment and their level of preparedness for these roles.

A cross-sectional survey of the 1992 and 1993 graduates from Army Family Practice Residencies was done to determine their non-clinical roles and their perceived level of preparedness for these roles. Sixty-nine of the 98 questionnaires mailed (70%) were returned. The non-clinical roles were divided into command, administrative, committee (subdivided into hospital level and department/clinic level), and duties outside of the hospital (subdivided into military and administrative). Twenty-nine (42%) had commands, 58 (84%) had administrative roles, 48 (70%) had hospital committee roles, 53 (77%) had department/clinic committee roles, 54 (78%) had military roles, and 42 (61%) had administrative roles outside of the hospital or clinic. The self-reported level of preparedness, on a five point Likert scale (1 = not at all, 3 = adequately, 5 = superbly), ranged from 2.2 for command to 2.9 for administrative roles outside the hospital. Residents did not feel adequately prepared for their non-clinical roles.

Cross-Sectional Studies↗
PubMed2026

Global vaccine readiness: equity-by-design in pandemic preparedness and response.

INTRODUCTION: COVID-19 showed that rapid vaccine development and roll-out, while lifesaving, can still yield large, avoidable harms when equity is not considered from the outset. Disparities in vaccine timing and coverage, especially in low-resource settings, amplified health and economic burdens, highlighting the need for preparedness frameworks that combine speed with fairness. AREAS COVERED: We synthesize evidence from literature and policy reports regarding global vaccine roll-out, focusing on avertable mortality under alternative sharing scenarios, procurement design, pooled mechanisms such as COVAX, and the role of distributed manufacturing and delivery capacity. We also examine how transparent data-sharing, effective public communication, genomic surveillance, adaptive trial designs, and modeling hubs can support more responsive and equitable vaccine deployment. Across six reflection points, we translate these lessons into practical priorities for future pandemic readiness, including strengthening healthcare infrastructure, equitable procurement, data transparency, and safeguarding public health decision-making from political and commercial distortion. EXPERT OPINION: We argue that equity-by-design is essential if vaccine innovation is to deliver equitable public health impact. This requires geographically distributed manufacturing, transparency, equity-conditioned advance purchase agreements, and pre-agreed, epidemiology-triggered allocation of vaccines. We recommend institutionalizing disaggregated reporting, standardized data-sharing, greater pathogen genomic sequencing capacity, and communication strategies that support public health protection while countering misinformation.

Humans↗
PubMed2026

Nipah virus in the era of global connectivity: molecular evolution, transmission risk, and preparedness strategies.

Nipah virus (NiV) is a highly pathogenic zoonotic RNA virus belonging to the genus Henipavirus within the family Paramyxoviridae, representing a continuing global health concern due to its high case fatality rate and potential for epidemic expansion in the era of increasing international connectivity. The virus demonstrates strong evolutionary adaptability driven by the absence of proofreading mechanisms during RNA replication, enabling genetic diversification that may influence host range, virulence, and transmission dynamics. Molecular pathogenesis of NiV is primarily mediated through interaction of viral glycoproteins with ephrin-B2 and ephrin-B3 receptors, facilitating host cell entry, endothelial damage, and neuroinvasion. Immune evasion facilitated by the action of accessory proteins encoded by the P gene (P, V, W, and C) acts to suppress innate antiviral immunity through the inhibition of interferon induction and JAK/STAT signaling. Human-to-human transmission of Nipah virus remains limited, with epidemiological evidence indicating basic reproduction numbers generally below unity; however, respiratory involvement and healthcare-associated exposure may enhance cluster outbreaks. Global travel, ecological disruption, and fragmented surveillance systems contribute to spillover risk, particularly in South and Southeast Asia where fruit bats of the genus Pteropus serve as natural reservoirs. Despite advances in vaccine technology, including subunit, viral vector, mRNA-based platforms, and monoclonal antibody therapies, no licensed prophylactic or therapeutic agent is currently available for human use. Global preparedness remains challenged by the scarcity of high-containment biosafety facilities, limited research funding, and absence of integrated One Health surveillance networks. Ethical considerations surrounding wildlife population control further complicate disease mitigation strategies. Emerging genomic surveillance, artificial intelligence-assisted predictive modeling, and regional data-sharing frameworks are essential for early detection and response. Strengthening molecular research on viral-host interactions and transmission determinants will be critical for preventing future Nipah virus outbreaks in an increasingly interconnected world.

Genomic surveillance↗
PubMed2004

Foundations of the severe acute respiratory syndrome preparedness and response plan for healthcare facilities.

OBJECTIVE: To help facilities prepare for potential future cases of severe acute respiratory syndrome (SARS). DESIGN AND PARTICIPANTS: The Centers for Disease Control and Prevention (CDC), assisted by members of professional societies representing public health, healthcare workers, and healthcare administrators, developed guidance to help facilities both prepare for and respond to cases of SARS. INTERVENTIONS: The recommendations in the CDC document were based on some of the important lessons learned in healthcare settings around the world during the SARS outbreak of 2003, including that (1) a SARS outbreak requires a coordinated and dynamic response by multiple groups; (2) unrecognized cases of SARS-associated coronavirus are a significant source of transmission; (3) restricting access to the healthcare facility can minimize transmission; (4) airborne infection isolation is recommended, but facilities and equipment may not be available; and (5) staffing needs and support will pose a significant challenge. CONCLUSIONS: Healthcare facilities were at the center of the SARS outbreak of 2003 and played a key role in controlling the epidemic. Recommendations in the CDC's SARS preparedness and response guidance for healthcare facilities will help facilities prepare for possible future outbreaks of SARS.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

Contextual stimulus control of conditional vasomotor and electrodermal reactions to angry and friendly faces. Transswitching--yes! Preparedness--No!

An experiment with 42 human Ss used the transswitching procedure to examine tonic stimulus control of phasic and tonic conditioned vasomotor heart rate, and electrodermal reactions. The conditional stimulus (CSs) were photos of angry and friendly human faces, and the unconditional stimulus (US) was a human scream. In one tonic context (blue light), the CSs were paired with the US, in the other context (yellow light), the CSs were presented unpaired. Following acquisition, an extinction series was run with the US omitted during both tonic contexts. Phasic vasomotor and skin conductance reactions differed in the positive and negative tonic segments (stronger in positive). The skin conductance responses also differed during extinction, but the vasomotor responses did not. Tonic differences (following onset of the tonic stimuli) in unelicited skin conductance response frequency, finger pulse volume, and heart rate were also found, although these developed more slowly than the phasic differences. The finger pulse volume tonic difference was greater in extinction than the skin conductance response frequency. There was no effect of the angry-friendly facial expressions, either directly or in interaction with the transswitching effects. The results were interpreted to mean that the transswitching phenomenon is not limited to one another autonomic effector, but is more generalized across the ANS (sympathetic branch). The absence of influence of the facial expressions indicates the relative weakness of the "preparedness" hypothesis in comparison with more influential contextual factors.

Adult↗
PubMed2006

Hospital preparedness to bioterrorism and other infectious disease emergencies.

In the last 2 decades, successive outbreaks caused by new, newly recognised and resurgent pathogens, and the risk that high-consequence pathogens might be used as bioterrorism agents amply demonstrated the need to enhance capacity in clinical and public health management of highly infectious diseases. In this article we review these recent and current threats to public health, whether naturally occurring or caused by accidental or intentional release. Moreover, we discuss some components of hospital preparedness for, and response to, infectious disease of the emergencies in developed countries. The issues of clinical awareness and education, initial investigation and management, surge capacity, communication, and caring for staff and others affected by the emergency are discussed. We also emphasise the importance of improving the everyday practice of infection control by healthcare professionals.

Bioterrorism↗
PubMed2003

Preparedness in robotically assisted interventions.

For many years, robots have been used in manufacturing to perform a variety of delicate tasks. Their use is now being generalized to other fields, such as biology, domestic applications, and especially medicine, in which they are poised to make a significant contribution. This evolution comes from the progress made in the field of robotics and from recent changes in medical and surgical techniques, namely, developments in medical imaging and a new desire for minimally invasive interventions. This emerging combination of high-precision robotic manipulators, new medical diagnostic techniques, and efficient minimally invasive surgery has not yet been perfected. After a brief discussion of state-of-the-art robotic systems used in urology, this article discusses new challenges presented by robotic minimally invasive surgery. A computer-integrated approach aimed at increasing the efficiency of such interventions through better preparedness is presented. This approach is illustrated by a case study in human nephrectomy and a cardiac animal experiment.

Humans↗
PubMedDate not supplied

Do rat strain differences in ethanol consumption reflect differences in ethanol sensitivity or the preparedness to learn?

Three strains of rats (Wistar, Sprague-Dawley, Long-Evans; n = 10/strain) were trained to drink various concentrations of ethanol (ETOH) in the rats' home cage in daily 30-min drinking sessions using a modified "Samson" sucrose-fading procedure. Wistar and Sprague-Dawley rats were similar in their voluntary intake of a wide range of ETOH concentrations and both of these strains drank considerably more ETOH than the Long-Evans strain. For comparison purposes only, pharmacological pretreatment tests were later conducted with the Sprague-Dawley strain of rats using a maintenance concentration of 20% w/v ETOH. Low-dose ETOH pretreatments increased (125% of control), and high-dose ETOH pretreatments decreased the subsequent voluntary consumption of ETOH. Low-dose nicotine pretreatments increased ETOH consumption to 148% of control intake, and high doses of nicotine decreased ETOH consumption. Both opiate antagonists, naloxone and naltrexone, produced dose-dependent decreases in ETOH consumption. The dopamine antagonist, haloperidol, produced dose- and time-dependent increases in voluntary ETOH consumption. The strain differences in voluntary ETOH consumption described in the present study differ from those previously described by other labs. We suggest that this strain-dependent disparity between laboratories, with respect to ETOH consumption/preference tasks, may reflect genetic differences in the preparedness to condition (learn) voluntary ETOH consumption rather than genetic differences in ETOH's reward/reinforcement attributes.

Alcohol Drinking↗
PubMed2005

A national curriculum for nurses in emergency preparedness and response.

Preliminary and continuing education concerning emergency preparedness is needed for nurses. Although some nurses have had natural disaster training, most have not had training to respond to bioterrorism events. Several organizations are working to develop standards and curricula for such training. This article highlights these efforts.

Curriculum↗